diabetes

Question 1

screening for neuropathy in a diabetic patient should be come with what apparatus?

Answer 1

a 10 g monofilament is used on various parts of the sole of the foot

Question 2

true or false -
Patients with impaired glucose tolerance are more likely to develop diabetes than patients with impaired fasting glycaemia

Answer 2

true

Question 3

A HbA1c of what level is indicative of prediabetes.

Answer 3

42-47 mmol/mol

Question 4

Addison’s patient unwell what advice should they be given in regard to the dose of their hydrocortisone and fludrocortisone?

Answer 4

double the dose of hydrocortisone. keep the same does of fludrocortisone

Question 5

what are the side effects of Sulfonylureas

Answer 5

Common adverse effects

hypoglycaemic episodes (more common with long acting preparations such as chlorpropamide)
weight gain

Rarer adverse effects

syndrome of inappropriate ADH secretion
bone marrow suppression
liver damage (cholestatic)
peripheral neuropathy

Question 6

What is the target for blood pressure for patients with type 2 diabetes with no organ damage and with end organ damage ?

Answer 6

no organ damage: < 140 / 80

end-organ damage: < 130 / 80

Question 7

Hyperosmolar hyperglycaemic state (HHS) is confirmed by:

Answer 7

Dehydration
serum Osmolality >320mosmol/kg
Hyperglycaemia >30 mmol/L with pH >7.3, bicarbonate >15mmolL and no significant ketonenaemia < 3mmol/

Question 8

A 19-year-old, known type 1 diabetic, attends the emergency department with diabetic ketoacidosis. 1 litre of 0.9% saline has been given and you are asked to set up an insulin infusion for the patient. What is the correct rate of insulin you should prescribe according to current NICE guidelines?

Answer 8

According to current NICE guidelines on the management of DKA, the infusion of insulin should be started at 0.1 unit/kg/hr.