7239533
Frage 1
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[blank_start]Diabetes Mellitus (DM)[blank_end] is actually a group of metabolic disorders characterized by hyperglycemia which results from defect in secretion of insulin, action of insulin, or both
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Diabetes
Frage 2
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What counterregulatory hormones are responsible for the decrease in insulin release when blood glucose levels drop? (select all that apply)
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Glucagon
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growth hormone
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glucocorticoids
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epinephrine
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thyroid hormone
Frage 3
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[blank_start]DDP-IV[blank_end] enzymes are responsible for the break down of gut incretins GLP-1 and GIP.
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DPP-IV
Frage 4
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Insulin is secreted from ___________.
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alpha cells
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beta cells
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gamma cells
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delta cells
Frage 5
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What would you check to see if a person is in fact making insulin?
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preproinsulin
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proinsulin
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C peptide
Frage 6
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GLUT
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potassium
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depolarization
Frage 7
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Meal ingestion causes the rapid release of insulin and [blank_start]amylin[blank_end] from the pancreas.
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amylin
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proinsulin
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c peptide
Frage 8
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Type 1 DM is the abosulte deficiecny of amylin and insuilin.
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- True
- False
Frage 9
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Which of the following is NOT an effect of amylin?
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increases rate of gastric emptying
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inhibits glucagon
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reduces gastric emptying
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induces post-prandial satiety
Frage 10
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In glucose homeostasis, 40% of gluconeogeneiss occurs in the [blank_start]kidneys[blank_end] and reabsoprtion of glucose occurs in the [blank_start]proximal tubule[blank_end].
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kidneys
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proximal tubule
Frage 11
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Fill in the blanks with appropriate values used to diagnose a patient with PRE-DIABETES according to ADA guidelines?
FPG/IFG: [blank_start]100-125mg/dL[blank_end]
2-hr OGTT/IGT: [blank_start]140-199mg/dL[blank_end]
A1c: [blank_start]5.7% - 6.4%[blank_end]
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50-100mg/dL
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100-125mg/dL
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150-200mg/dL
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200-225mg/dL
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100-125mg/dL
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140-199mg/dL
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220=250mg/dL
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5.7% - 6.4%
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7% -7.5%
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8% - 8.5%
Frage 12
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β-cell destruction usually leading to absolute insulin and amylin deficiency.
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Type 1 DM
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Type 2 DM
Frage 13
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“Progressive insulin secretory defect (β-cell dysfunction) on the background of insulin resistance.
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Type 1 DM
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Type 2 DM
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Gestational DM
Frage 14
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Diabetes diagnosed during pregnancy that IS NOT clearly overt diabetes
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Type 1 DM
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Type 2 DM
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Gestational Diabetes
Frage 15
Antworten
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< 30 years
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> 30 years
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abrupt
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gradual
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lean
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obese or history of obesity
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present
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absent
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rarely present
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often present
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often asymptomatic
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symptomatic
-
absent
-
present
-
immediate
-
years after diagnosis
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HHS
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DKA
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Yes
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No
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Rare
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Common
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< 30 years
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> 30 years
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abrupt
-
gradual
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obese or history of obesity
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lean
-
absent
-
present
-
often present
-
rarely present
-
symptomatic
-
often asymptomatic
-
present
-
absent
-
immediate
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years after diagnosis
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DKA
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HHS
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NO
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Common
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rare
-
common
Frage 16
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Which of the following below are symptoms of HYPERglycemia? (select all that apply)
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polydipsia
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polyuria
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polyphagia
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dry skin
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blurry vision
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drowsy
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slow healing wounds
Frage 17
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During pregnanacy, the placenta can produce hormones that contribute to insulin resistance.
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- True
- False
Frage 18
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Criteria for the diagnosis of diabetes;
(1) A1C > [blank_start]6.5[blank_end]%
(2) FPG > [blank_start]126[blank_end] mg/dL
(3) 2-hr PG > [blank_start]200[blank_end] mg/dL after a 75 gram oral glucose tolerance test (OGTT)
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126
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200
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6.5
Frage 19
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Acanthosis Nigricans is associated with ....
Antworten
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Type 1 DM
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Type 2 DM
Frage 20
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Children with BMI precentile of [blank_start]85[blank_end] or greater should be considered for screening for T2DM
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85
Frage 21
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When should pregnant women without overt DM should be screeened for gestational diabetes mellitus?
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15-20 weeeks
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20-22 weeks
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24-28 weeks
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30-33 weeks
Frage 22
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Gestational diabetes mellitus should be tested for a second time 2-3 weeks post partum.
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- True
- False
Frage 23
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Which of the following are complications of DM in pregnancy (select all that apply)
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gestational HTN
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Preecalmpsia
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Gestational HYPOtension
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infections
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ketoacidosis
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polyhrdramnios
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preterm labor
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seizures
Frage 24
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Fill in the appropriate values for the ACOG: Carpenter and Coustan 100mg OGTT 3hr (mg/dL) which is used in the diagnosis of GDM.
Fasting: [blank_start]95[blank_end]
1 hour: [blank_start]180[blank_end]
2 hours: [blank_start]155[blank_end]
3 hours: [blank_start]140[blank_end]
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95
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180
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155
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140
Frage 25
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What are the glycemic goal for patients with GDM and preexisting DM?
(1) Fasting less than or equal to [blank_start]95[blank_end] mg/dL
(2) 1-hr PP less than or equal to [blank_start]140[blank_end] mg/dL
(3) 2-hr PP less than or equal to [blank_start]120[blank_end] mg/dL
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95
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140
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120
Frage 26
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During pregnancy an A1C of [blank_start]6-6.5[blank_end] % is the reccomeneded target in the second and third trimester but < [blank_start]6[blank_end] % may be optimal.
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6-6.5
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6
Frage 27
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During pregnancy insulin resistance decreases as pregnancy progresses
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- True
- False
Frage 28
Frage
Hypoglycemia is usually defined as < 70 mg/dl but in pregnancy BG is often allowed to be than [blank_start]60[blank_end] mg/dL
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60
Frage 29
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Indicate which insulins and oral medications are utilized in the treatment of diabetes during pregnancy?
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Metformin
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Lantus
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Glargine
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NPH
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Regular insulin
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Glyburide
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Apidra
Frage 30
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[blank_start]Insulin[blank_end] is the first-line agent recommended for treatment of GDM in the U.S
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Insulin
Frage 31
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[blank_start]Glyburide[blank_end] may be inferior to metformin and insulin due to increased risk of neonatal hypoglycemia and macrosomia
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Glyburide
Frage 32
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[blank_start]Aspart[blank_end] and [blank_start]Lispro[blank_end] are the only rapid-acting insulins approved during pregnancy
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Aspart
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Lispro
Frage 33
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[blank_start]Detemir[blank_end] is the only long-acting basal insulin utilized to treat diabetes in pregnancy
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Detemir
Frage 34
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What are the glucose levels for insulin initiation in GDM
Fasting PG less than or equal to [blank_start]105[blank_end] mg/dL
1-hours postprandial plasma glucose less than or equal to [blank_start]155[blank_end] mg/dL
2-hour postprandial plasma glucose less than or equal to [blank_start]130[blank_end] mg/dL
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105
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155
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130
Frage 35
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T1DM will require insulin during labor while most do not require insulin during labor and delivery with GDM
Antworten
- True
- False
Frage 36
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What immunizations are reccomended for diabetic patients?
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influnenza
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pneumococal
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hepatitis B
Frage 37
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Hypoglycemia is indicated with a BG of less than [blank_start]70[blank_end] mg/dL
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70
Frage 38
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1) If blood glucose (BG) is less than 70 mg/dL, you should give [blank_start]15[blank_end] grams of carbs and recheck the blood glucose after 15 minutes.
2) If blood glucose is less than 50 mg/dL , you should give [blank_start]30[blank_end] grams of carbs and recheck the blood glucose after 15 minutes
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15
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30
Frage 39
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15g is equal to:
[blank_start]1[blank_end] tablespoon of sugar, [blank_start]3-4[blank_end] hard candies, [blank_start]4[blank_end] oz regular fruit juice, [blank_start]6[blank_end] oz regular soda, 3-4 glucose tablets, 6 lifesvavers save a life
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1
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3-4
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4
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6
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3-4
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1
-
4
-
6
-
4
-
1
-
3-4
-
6
-
6
-
4
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1
-
3-4
Frage 40
Frage
Which of the following should be part of the sick day management plan?
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Check BG more frequently
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Try to keep BG < 200 mg
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Contiune basal insulin
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Stay hydrated
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use liquid carbohydrates to keep BG stable if unable to keep food down or having frequent or severe drops in BG
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May need to hold prandial insulin or some oral medications if unable to keep down any carbohydrates.
Frage 41
Frage
What are the possible causes of DKA?
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Exacerbated by an increase in counterregulatory hormones – hyperglycemic crisis
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Insulin deficiency promotes lipolysis and metabolism of FFA to β-hydroxybutyrate, acetoacetic acid, and acetone in the liver
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Excess glucagon enhance gluconeogenesis and impairs peripheral ketone utilization
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Reduction in the effective circulating insulin with a concomitant elevation of counter-regulatory hormones
Frage 42
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What are the causes of HHS?
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Excess glucagon enhance gluconeogenesis and impairs peripheral ketone utilization
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Reduction in the effective circulating insulin with a concomitant elevation of counter-regulatory hormones
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Consistently elevated blood glucose concentration (sometimes weeks) in the face of reduce fluid intake
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Most commonly preceded by infection or other serious illness
Frage 43
Antworten
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0.9% NaCl
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0.45% NaCl
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0.9% NaCl
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200
-
300
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0.1
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0.14
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0.14
Frage 44
Antworten
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3.3
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5.2
Frage 45
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In hospital care, treat if the blood glucose is above [blank_start]180[blank_end] mg/dL with a goal between [blank_start]140-180[blank_end] mg/dL.
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180
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140-180
Frage 46
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In what conditions should you consider lowering the dose of basal insulin by 20%?
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renal insufficiency or failure exisit
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Heart failure
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tapering off coticosteriod medications
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no history of diabetes
Frage 47
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Turn off insulin infusion [blank_start]2[blank_end] hours after administration of SubQ basal insulin
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2
Frage 48
Antworten
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Type 1
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Type 2
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Hours to days
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Days to weeks
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> 250
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>600
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< 7.35
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7.35-7.45
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Present
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Absent or very little
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< 320
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> 320
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Type 2
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Type 1
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Hours to days
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Days to weeks
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> 250
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> 600
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< 7.35
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7.35 - 7.45
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Present
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Absent or very little
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< 320
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> 320
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