Antidiabetic drugs: GLP-1 agonists: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antidiabetic drugs: GLP-1 agonists

Sample item

A 45-year-old obese woman with type 2 diabetes is considered for weekly semaglutide. Which history is a contraindication?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Family history of medullary thyroid carcinoma or MEN type 2

GLP-1 receptor agonists caused C-cell tumours in rodents, so they are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or MEN 2. Other cautions include a history of pancreatitis, and common adverse effects are nausea and vomiting. Fatty liver and hypertension are not contraindications.

Option by option

  • A. Intolerance of metformin

    Metformin intolerance is a reason to use alternative drugs, not a contraindication to GLP-1 agonists.

  • B. Hypertension controlled on amlodipine

    Controlled hypertension does not preclude use.

  • C. Mild fatty liver on ultrasound

    Fatty liver may even improve with these drugs.

  • D. Family history of medullary thyroid carcinoma or MEN type 2 (correct)

    Correct. This is the labelled contraindication, related to the thyroid C-cell warning.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Family history of medullary thyroid carcinoma or MEN type 2. GLP-1 receptor agonists caused C-cell tumours in rodents, so they are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or MEN 2.

Why is "Intolerance of metformin" not the answer?

Metformin intolerance is a reason to use alternative drugs, not a contraindication to GLP-1 agonists.

Why is "Hypertension controlled on amlodipine" not the answer?

Controlled hypertension does not preclude use.

Why is "Mild fatty liver on ultrasound" not the answer?

Fatty liver may even improve with these drugs.

What concept does this question test?

It tests Antidiabetic drugs: GLP-1 agonists in Pharmacology. Other cautions include a history of pancreatitis, and common adverse effects are nausea and vomiting. Fatty liver and hypertension are not contraindications.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidiabetic drugs: GLP-1 agonists?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.