What every dentist should know about metformin, diabetes, and cancer

Self-Instruction Exercise No. 375
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Exercise No. 375
Subject Code: 016
Pharmacotherapeutics

The 15 questions for this exercise are based on the article, What every dentist should know about metformin, diabetes, and cancer, on pages 70-72. This exercise was developed by Anthony S. Carroccia, DDS, MAGD, ABGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • discuss basic facts about metformin;
  • recognize its side effects; and
  • understand its potential role in the treatment of head and neck cancer.

Answers for this exercise must be received by August 31, 2016.
  1. All of the following are brand names for metformin except one. Which is the exception?

    A. Glucophage
    B. Carbophage
    C. Glumetza
    D. Carbomet

  2. The primary mechanism of action of metformin is to increase basal hepatic glucose production. Another mechanism is improvement of peripheral insulin sensitivity.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  3. Metformin has been associated with all of the following except one. Which is the exception?

    A. decreased cholesterol
    B. decreased high-density lipoprotein
    C. decreased low-density lipoprotein
    D. decreased weight

  4. Women with polycystic ovary syndrome who are taking metformin may see which of the following occurrences?

    A. amenorrhea
    B. cystic conversion to tumors
    C. induction of ovulation
    D. lysis of cysts

  5. A retrospective study found that breast cancer patients not taking metformin with chemotherapy had a(n) ____% recovery rate.

    A. 8
    B. 18
    C. 24
    D. 53

  6. Metformin completely inhibits the mitochondrial respiratory chain complex I. Metformin might directly inhibit cancerous growth by lowering glucose and insulin.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  7. Cancer cells thrive in an environment of high ____________ and _____________.

    A. glucose; glucagon
    B. glucose; insulin
    C. insulin; glucagon
    D. insulin; glycogen

  8. Metformin has the potential to treat all of the mentioned cancers except one. Which is the exception?

    A. breast
    B. lung
    C. testicular
    D. uterine

  9. The head and neck cancer 5-year survival rate is approximately ____%.

    A. 50
    B. 60
    C. 75
    D. 85

  10. All of the following are risk factors for head and neck cancer except one. Which is the exception?

    A. alcohol use
    B. diabetes mellitus
    C. human papillomavirus infection
    D. tobacco use

  11. Head and neck cancer surgery can result in dysphagia, dysarthria, and damage to structures. Radiotherapy is the less preferred cancer treatment because it is less accurate and results in an increase in caries.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  12. The effect of metformin occurs primarily in the ____________ layer of oral premalignant lesions.

    A. basal
    B. fatty
    C. keratin
    D. spinous

  13. Metformin prevents the development of head and neck squamous cell carcinoma (HNSCC) by reducing the number and size of tumor-induced oral lesions. Metformin inhibits HNSCC without causing any prominent cell death.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  14. All of the following are gastrointestinal side effects of metformin except one. Which is the exception?

    A. anorexia
    B. constipation
    C. abdominal pain
    D. nausea

  15. When a patient takes metformin, which of the following vitamins could be reduced?

    A. biotin
    B. cobalamin
    C. riboflavin
    D. thiamine

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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