DM practice

Question 1

“Rocker bottom” deformity results from untreated what?
a) Peripheral Neuropathy
b) Charcot foot
c) Candidal infection
d) Incomplete bladder functioning

Answer 1

b) Charcot foot

Question 2

The leading cause of death in pts with type 2 diabetes is what?
a) MI
b) Hyperglycemia
c) Myxedema coma
d) Neuropathy

Answer 2

a) MI

Question 3

Weakness, Kussmaul breathing, Tachycardia, and N/V are all symptoms of what?
a) HHS
b) Myxedema coma
c) DKA
d) Autonomic neuropathy

Answer 3

c) DKA

Question 4

Hyperglycemia >600 and a normal anion gap are indicative of what?
a) HHS
b) Myxedema coma
c) DKA
d) Autonomic neuropathy

Answer 4

a) HHS

Question 5

Which drug/ drug class has a risk of AKI in pts that receive contrast dye while taking it?
a) Sulfonylureas
b) Metformin
c) Thiazolidinediones (glitazones)
d) GLP-1 receptor agonists

Answer 5

b) Metformin

Question 6

Polyuria, polydipsia and weight loss are the key Sx of what?
a) T1DM
b) T2DM
c) DI

Answer 6

a) T1DM

Question 7

T/F: DM Type 1b has no beta cell destruction

Answer 7

True

Question 8

Which of the following is not a typical symptom of T2DM?
Polyuria
Polydipsia
Ketonuria

Answer 8

Ketonuria

Question 9

Labs are looking for beta hydroxybutyrate and aceto-acetate for diagnosing what?
a) Ketones in urine
b) Glucose in urine
c) Protein in urine

Answer 9

a) Ketones in urine

Question 10

Conditions that increase erythrocyte survival, like ___________, falsely raise HbA1c
a) Hemochromatosis
b) Iron deficiency anemia
c) Hemolysis
d) EPO

Answer 10

b) Iron deficiency anemia

Question 11

What reflects the state of glycemic control over the last 1-2 weeks?
a) Glucose
b) HbA1C
c) Fructosamine
d) None of the above

Answer 11

c) Fructosamine

Question 12

Which study showed that tighter control of BP (median value 144/82 vs mean of 154/87) substantially reduced risk of microvascular disease and stroke, more so than A1C?

Answer 12

The UK Prospective Diabetes Study (UKPDS)

Question 13

For T2DM, initiate insulin for symptomatic patients when A1C >____% or blood glucose ≥ 300 mg/dL

Answer 13

> 10%; ≥300

Question 14

The Somogyi effect occurs when nocturnal __________leads to a compensatory ___________ in the morning
a) hyperglycemia; hypoglycemia
b) hypoglycemia; hyperglycemia

Answer 14

b) Hypoglycemia; hyperglycemia

Question 15

GLP-1, SGL-2, and metformin all have what in common?
a) Harmful to kidney function
b) Cardiovascular benefits
c) Harmful in heart failure

Answer 15

b) Cardiovascular benefits

Question 16

GLP-1 and DPP-4 have what in common?
a) Harmful to kidneys
b) Liver failure
c) Pancreatitis
d) N/V

Answer 16

c) Pancreatitis

Question 17

What drugs end in flozin?
a) SGL2
b) GLP1
c) DPP4 inhibitors
d) TZDs

Answer 17

a) SGL2

Question 18

Which have the highest risk of genital infections?
a) SGL2
b) GLP1
c) DPP4 inhibitors
d) TZDs

Answer 18

a) SGL2

Question 19

_________________ and insulins have increased risk of weight gain

Answer 19

Sulfonylureas

Question 20

Metformin and ______ are weight neutral

Answer 20

DPP-4

Question 21

When are TZDs/glitazones contraindicated?

Answer 21

HF classes 3 & 4

Question 22

What has a risk of fractures, macular edema, and bladder cancer?
a) SGL2
b) GLP1
c) DPP4 inhibitors
d) TZDs

Answer 22

d) TZDs

Question 23

What are your two cheapest meds?

Answer 23

Metformin and sulfonylureas

Question 24

Metformin 850mg BID reduces risk of developing what?

Answer 24

T2DM (unless minimally obese or rlly old)

Question 25

After 20 years, 60% of type II and virtually all of pts with type I will have what symptom? a) Diabetic cataracts b) Diabetic retinopathy c) Diabetic nephropathy d) Diabetic neuropathy

Answer 25

b) Diabetic retinopathy

Question 26

Which type of retinopathy is known to get worse after bariatric surgery and continue when hyperglycemia is under control? a) Proliferative b) Non-proliferative

Answer 26

b) Non-proliferative

Question 27

An albumin:creatinine ratio greater than ____mcg/mg suggests abnormal microalbuminuria. a) 10 mcg/mg b) 20 mcg/mg c) 30 mcg/mg d) 40 mcg/mg

Answer 27

c) 30 mcg/mg

Question 28

What is generally the first manifestation of diabetic nephropathy? a) Albuminuria b) Urea increase c) Creatinine increase

Answer 28

a) Albuminuria

Question 29

What is the main treatment for diabetic nephropathy? What is the main treatment for kidney disease? a) ACEis; SGL-2is b) ARBs; GLP-1s c) ACEis; GLP-1s d) ACEis; spironolactone

Answer 29

a) ACEis; SGL-2is

Question 30

What kind of potassium derangement do you get with fludrocortisone?

Answer 30

Hypokalemia

Question 31

Name a symptom of diabetic neuropathic cachexia

Answer 31

Dramatic weight loss

Question 32

Neuropathic pain can be treated with what two things? Select two a) SSRIs b) SNRIs c) Tricyclic antidepressants d) Gabapentin

Answer 32

c) Tricyclic antidepressants d) Gabapentin

Question 33

What is treated with metoclopramide or erythromycin? a) Diabetic neuropathy b) Diabetic dysuria c) Diabetic nephropathy d) Diabetic gastroparesis

Answer 33

d) Diabetic gastroparesis

Question 34

Which of the following can you treat with fludrocortisone? a) Incomplete bladder functioning b) Erectile dysfunction c) Orthostatic hypotension d) Potassium derangement

Answer 34

c) Orthostatic hypotension

Question 35

Which drugs and in -gliptin?

Answer 35

DPP4s