Metabolic Diseases Flashcards
(202 cards)
1
Q
What do we NOT advise on nutrition after diabetes is diagnosed?
a. as little as possible of all carbohydrates
b. as many different vegetables as possible
c. avoiding white bread
d. as little fat as possible
e. avoiding simple sugars
A
a. as little as possible of all carbohydrates
2
Q
Metabolic syndrome is characterized by:
a. uremia
b. hyperinsulinemia
c. hypoinsulinemia
d. hyperglucagonemia
e. hypoglucagonemia
A
b. hyperinsulinemia
3
Q
Chronic hyperglycemia can be caused by:
a. hyperthyroidism
b. Cushing’s disease
c. acromegaly
d. pheochromocytoma
e. all of the above
A
e. all of the above
4
Q
The final secretions of the beta cell of the pancreas are:
a. insulin
b. insulin, C-peptide
c. insulin, C-peptide, proinsulin
d. insulin, C-peptide, proinsulin, preproinsulin
e. insulin, C-peptide, proinsulin, preproinsulin, glucose
A
c. insulin, C-peptide, proinsulin
5
Q
The recommended diet of a patient with diabetes includes:
a. 45-60% carbohydrates
b. 45-60% protein
c. 45-60% fat
d. lots of fiber
A
a. 45-60% carbohydrates
d. lots of fiber
6
Q
Lack of insulin in the body causes
a. lipolysis
b. central lipolysis, peripheral lipogenesis
c. increased gluconeogenesis
d. reduced gluconeogenesis
e. proteolysis
f. increased protein synthesis
A
a. lipolysis
c. increased gluconeogenesis
e. proteolysis
7
Q
Hyperglycemia in pregnancy can cause
a. fetal diabetes
b. hypoplasia of pancreatic beta cells
c. fetal anomalies
d. dehydration of the fetus
e. lack of amniotic sac
A
c. fetal anomalies
8
Q
Microalbuminuria:
a. It is a specific change in diabetic kidney disease
b. It means increased excretion of albumins in the urine
c. It means reduced excretion of albumins in the urine
d. It means the excretion of small albumins in the urine
e. It is a worse prognostic factor for the progression of renal disease in SB type 1
than in SB type 2
A
b. It means increased excretion of albumins in the urine
9
Q
Identify the correct statements
a. Diabetes is an etiologically heterogeneous disease.
b. Diabetes is often asymptomatic.
c. The level of glucose tolerance may vary in patients with impaired glucose
tolerance
A
All of them
10
Q
Diabetes occurs more often in the following disease:
a. albinism
b. Cushing’s syndrome
c. nephrotic syndrome
d. sarcoidosis
e. chronic inflammatory bowel disease
A
b. Cushing’s syndrome
11
Q
Choose the correct statements:
a. genetic defects in insulin action are an important mechanism of diabetes
b. many people with type 2 diabetes have undiagnosed diabetes
c. In the incidence of type 1 diabetes, Slovenia is at the very top among European
countries
A
b. many people with type 2 diabetes have undiagnosed diabetes
12
Q
C-peptide is characterized by:
a. It is secreted from the beta-cells of the pancreas
b. It is formed from a precursor molecule in the bloodstream
c. It is secreted in an equimolar amount as insulin
d. May act as an inhibitor of insulin action
e. The formation depends on the concentration of blood glucose
A
a. It is secreted from the beta-cells of the pancreas
c. It is secreted in an equimolar amount as insulin
e. The formation depends on the concentration of blood glucose
13
Q
Secretion of insulin from beta-cells of the pancreas accelerates:
a. glucose
b. fatty acids
c. ketones
d. amino acids
A
All of them
14
Q
Glucose stimulates the beta-cell of the pancreas to secrete insulin:
a. through diffusion
b. via active transport
c. via an osmotic gradient
d. via binding to a receptor on the beta cell membrane
e. via binding to the intracellular beta cell receptor
A
d. via binding to a receptor on the beta cell membrane
15
Q
The main target tissue for insulin action is:
a. muscle, liver, fat
b. heart, liver
c. heart and brain
d. kidneys
e. erythrocytes
A
a. muscle, liver, fat
16
Q
The strongest stimulus for the secretion of insulin from the beta cell of the pancreas is:
a. glucose
b. fatty acids
c. ketones
d. arginine
e. isoleucine
A
a. glucose
17
Q
Choose the correct statements about insulin:
a. when it is lacking, catabolism prevails
b. in its absence, anabolism prevails
c. hepatic insulin extraction is greater after feeding
d. hepatic insulin extraction is greater during starvation
A
a. when it is lacking, catabolism prevails
c. hepatic insulin extraction is greater after feeding
18
Q
Choose the correct statements about insulin:
a. It is excreted constantly
b. It is excreted after meals
c. The most important effect in the liver is the inhibition of lipolysis
d. The most important effect in the liver is the stimulation of lipolysis
A
a. It is excreted constantly
c. The most important effect in the liver is the inhibition of lipolysis
19
Q
Metabolic syndrome includes:
a. impaired glucose tolerance
b. diabetes
c. impaired glucose tolerance, increased blood pressure
d. impaired glucose tolerance, increased blood pressure, waist circumference
e. impaired glucose tolerance, increased blood pressure, waist circumference, visual disturbances,
increased plasma triglycerides
A
d. impaired glucose tolerance, increased blood pressure, waist circumference
20
Q
In the diet recommended for patients with diabetes, they represent the largest
share (energy)
a. liquid
b. fats
c. proteins
d. carbohydrates
A
d. carbohydrates
21
Q
Are diabetes patients more susceptible to infections?
a. Yes
b. no
A
a. Yes
22
Q
Do acute illnesses increase the need for insulin?
a. Yes
b. no
A
a. Yes
23
Q
Which patient is more likely to require hospital treatment for a urinary tract
infection?
a. DM type 1
b. DM type 2, which is treated with a maximum dose of oral antihyperglycemic agents
A
b. DM type 2, which is treated with a maximum dose of oral antihyperglycemic agents
24
Q
It applies to the diet of a patient with diabetes without chronic complications
a. may contain simple sugars that are added to the mixed meal, but the
maximum allowed amount is 5 g
b. it must not contain simple sugars
c. protein should dominate
d. it is desirable to consume as much fiber as possible
A
d. it is desirable to consume as much fiber as possible
25
The most suitable diet for diabetes is:
a. a diet with as few carbohydrates as possible and as much protein as possible
b. a diet with as few carbohydrates and fats as possible and as much protein as possible
c. a diet with predominant components of fruits and vegetables
d. fasting diet
e. a diet based on healthy eating recommendations
e. a diet based on healthy eating recommendations
26
Circle the correct statement about nutrition in diabetes.
a. Foods containing simple carbohydrates are absolutely forbidden.
b. Carbohydrate foods should be distributed at all daily meals.
c. We avoid foods with carbohydrates.
d. Vitamins and minerals are important energy foods in the diabetes diet.
e. Because of the impact on the complications caused by hyperglycemia, we advise each
patient to supplement with antioxidants and minerals.
b. Carbohydrate foods should be distributed at all daily meals.
27
Type 1 diabetes is caused by
a. genetically conditioned pathological insulin molecules
b. destruction of beta cells due to autoimmune inflammation
c. destruction of beta cells in acute pancreatitis
d. changes in mitochondrial DNA
e. reduced regenerative abilities of pancreatic beta-cells
b. destruction of beta cells due to autoimmune inflammation
28
Type 1 diabetes is characterized by
a. when the disease is detected, antibodies to antigens are present, which are components of
the membrane and cytoplasm of the beta cell
b. typically, the pathogenetic process lasts a maximum of several weeks before the appearance of clinical
signs
c. clinical manifestation of the disease with mild and uncharacteristic symptoms
d. when the disease is discovered, ketoacidosis may be present
a. when the disease is detected, antibodies to antigens are present, which are components of
the membrane and cytoplasm of the beta cell
d. when the disease is discovered, ketoacidosis may be present
29
Type 1 diabetes is characterized by:
a. decreased function of the beta cells of the islets of Langerhans
b. increased insulin resistance
c. is more common than type 2 diabetes
d. in order to make a diagnosis, we perform tests on the most common antigens and
antibodies involved
a. decreased function of the beta cells of the islets of Langerhans
30
Type 1 diabetes is characterized by:
a. great kinship tendency
b. autoimmune features
c. possible lifelong insulin dependence
d. complete concordance of monozygotic twins
b. autoimmune features
c. possible lifelong insulin dependence
31
Type 1 diabetes applies to:
a. we see a seasonal variation in occurrence
b. we see a steady rise in incidence
c. a screening for it would be useful, but at the moment the health fund does not have
enough money
d. the peak of occurrence is in early childhood, when respiratory infections are also very common
a. we see a seasonal variation in occurrence
b. we see a steady rise in incidence
32
Type 1 diabetes is characterized by:
a. is predominantly immune-induced
b. is predominantly idiopathic
c. when the disease manifested, almost 50% of the beta cells died
d. three-quarters of the beta cells have died at the onset of the disease
e. when the disease manifests, practically all beta cells are destroyed
a. is predominantly immune-induced
d. three-quarters of the beta cells have died at the onset of the disease
33
In type 1 diabetes:
a. in addition to the islets of Langerhans, the exocrine pancreatic function is
often affected
b. apart from the islets of Langerhans, there is no characteristic impairment of the exocrine
pancreatic function
c. glucagon secretion is often affected in addition to the islets of Langerhans
d. glucagon secretion is not affected
e. the secretion of somatostatin is often affected due to the cytotoxic tissue
response
b. apart from the islets of Langerhans, there is no characteristic impairment of the exocrine
pancreatic function
d. glucagon secretion is not affected
34
Type 1 diabetes is characterized by an antibody:
a. ACE
b. MPO
c. NASTY
d. Ttg
e. EMA
c. NASTY
35
Newly diagnosed type 1 diabetes is clinically expressed by:
a. polyuria
b. oliguria
c. nocturia
d. weight reduction
e. weight gain
a. polyuria
c. nocturia
d. weight reduction
36
In type 2 diabetes we find:
a. albuminuria
b. hematuria
c. hypercalcemia
a. albuminuria
37
Type 2 diabetes is characterized by:
a. Insulin secretion is insufficient in every phase of the disease
b. Insulin secretion is sufficient in the initial stages, but then it decreases and becomes
insufficient
c. Insulin secretion is sufficient in all phases of the disease, hyperglycemia is the
result of insulin resistance
d. Insulin secretion is sufficient in all stages of the disease, hyperglycemia is the result of
uncontrolled hepatic gluconeogenesis
e. Insulin secretion is sufficient, but hyperglycemia is the result of both uncontrolled
hepatic gluconeogenesis and reduced responsiveness of fat and muscle to preexisting insulin
a. Insulin secretion is insufficient in every phase of the disease
38
What is specific about DM 2:
a. US small kidney
b. nephrotic syndrome
c. increased albuminuria
c. increased albuminuria
39
Untreated or newly diagnosed type 2 diabetes is clinically expressed by:
a. Polyuria
b. Oliguria
c. Nocturia
d. By reducing body weight
e. By increasing body weight
a. Polyuria
c. Nocturia
d. By reducing body weight
40
Patients with type 2 diabetes usually have the following characteristics:
a. under 40 years old
b. overweight
c. when the disease occurs, insulin secretion is insufficient
d. at the onset of the disease, insulin secretion is still present
e. family tendency
b. overweight
c. when the disease occurs, insulin secretion is insufficient
d. at the onset of the disease, insulin secretion is still present
e. family tendency
41
The basis of successful treatment of type 2 diabetes is
a. metformin
b. healthy balanced diet
c. insulin replacement
d. adequate hydration
e. combination therapy with metformin and a sulfonylurea
b. healthy balanced diet
42
Type 2 diabetes is characterized by:
a. tends to metabolic deterioration despite treatment
b. familial occurrence is not pronounced
c. when it appears, it manifests itself with a turbulent clinical picture
d. insulin secretion is not impaired
e. often occurs after frequent pancreatitis
a. tends to metabolic deterioration despite treatment
43
Type 2 diabetes applies to:
a. the incidence of occurrence is highest after the age of 65
b. the incidence is decreasing due to good prevention
c. pancreatic beta cell dysfunction has a characteristic tendency to worsen
d. an important risk factor for its occurrence is obesity
c. pancreatic beta cell dysfunction has a characteristic tendency to worsen
d. an important risk factor for its occurrence is obesity
44
Type 2 diabetes is characterized by:
a. the onset of the disease is sudden
b. etiopathogenesis is similar to impaired glucose tolerance
c. etiopathogenesis is similar to that of borderline basal glycemia
d. when diabetes develops, hyperinsulinemia may still be present
b. etiopathogenesis is similar to impaired glucose tolerance
d. when diabetes develops, hyperinsulinemia may still be present
45
Type 2 diabetes applies to:
a. it is a clinically homogeneous disease
b. it is a clinically heterogeneous disease
c. insulin responsiveness is impaired at both the postreceptor and prereceptor
levels
d. there is also always a defect in insulin secretion
b. it is a clinically heterogeneous disease
46
Type 2 diabetes applies to:
a. Slovenia has a lower disability than neighboring countries
b. Slovenia has a similar vulnerability to neighboring countries
c. It is more common in women
d. When discovered, it is mostly symptomatic
b. Slovenia has a similar vulnerability to neighboring countries
c. It is more common in women
47
MODY is:
a. form of type 1 diabetes
b. form of type 2 diabetes
c. a more severe course of diabetes is typical
d. a milder course of diabetes is typical
b. form of type 2 diabetes
d. a milder course of diabetes is typical
48
Type 2 diabetes:
a. is caused by a reduced ability to secrete insulin
b. upon discovery, all patients have symptomatic hyperglycemia
c. upon discovery, signs of involvement of the large vessels can be identified
d. upon discovery, signs of microangiopathy can be identified
a. is caused by a reduced ability to secrete insulin
c. upon discovery, signs of involvement of the large vessels can be identified
d. upon discovery, signs of microangiopathy can be identified
49
Type 2 diabetes is characterized by:
a. insulin secretion in the basal state is somewhat weaker in obese people
b. insulin secretion in the basal state is stronger in obese people
c. with the increase in glucose concentration after exercise, the secretion of insulin from
the pancreas increases proportionally
d. as the concentration of glucose increases after exercise, the secretion of insulin from
the pancreas decreases proportionally
b. insulin secretion in the basal state is stronger in obese people
c. with the increase in glucose concentration after exercise, the secretion of insulin from
the pancreas increases proportionally
50
Type 2 diabetes
a. there is no beta cell damage, but the primary pathogenesis is increased tissue resistance
b. mostly in obese people
c. can't get skinny people
a. there is no beta cell damage, but the primary pathogenesis is increased tissue resistance
b. mostly in obese people
51
The drug of choice for the initiation of treatment for type 2 diabetes is
a. metformin
b. insulin secretagogue
c. a drug that acts on the incretin system
d. insulin
a. metformin
52
For most patients with type 2 diabetes, the target HbA1c is
a. below 8.0%
b. below 6.5%
c. below 7.5%
d. below 7.0%
d. below 7.0%
53
Hyperglycemia in pregnancy can cause:
a. fetal diabetes
b. hypoplasia of pancreatic beta cells
c. fetal anomalies
d. dehydration of the fetus
e. lack of amniotic sac
c. fetal anomalies
54
Pregnancy DM is usually treated with:
a. diet and, if necessary, insulin
b. diet and, if necessary, with metformin
c. diet and, if necessary, herbal teas
d. only with a diet, because as a rule it is mild
e. diet and, if necessary, a sulfonylurea
a. diet and, if necessary, insulin
55
Choose the correct statements.
a. Pre-existing diabetic retinopathy and diabetic nephropathy can be
expected to worsen during pregnancy
b. Diabetes may reoccur during pregnancy, but glucose tolerance
normalizes after delivery.
c. Women who have had gestational diabetes have a high risk of developing type
1 diabetes.
a. Pre-existing diabetic retinopathy and diabetic nephropathy can be
expected to worsen during pregnancy
b. Diabetes may reoccur during pregnancy, but glucose tolerance
normalizes after delivery.
56
Circle the correct statements:
a. Diabetic retinopathy can worsen during pregnancy.
b. Diabetic nephropathy can worsen during pregnancy.
c. Hyperglycemia in pregnancy can cause diabetic fetopathy.
d. Hyperglycemia causes a higher number of late intrauterine deaths.
All of them
57
Circle the correct answers:
a. gestational diabetes is a risk factor for the later development of type 2
diabetes in the mother
b. diabetes in pregnancy is a risk factor for the later development of type 2
diabetes in the child
c. stricter control of the fetus in a mother with gestational diabetes is necessary
especially in the first trimester of pregnancy
d. untreated or poorly treated diabetes in pregnancy causes microsomia.
a. gestational diabetes is a risk factor for the later development of type 2
diabetes in the mother
b. diabetes in pregnancy is a risk factor for the later development of type 2
diabetes in the child
58
Circle the correct answers regarding diabetes in pregnancy.
a. Glucose passes into the placenta by active transport.
b. Maternal hyperglycemia causes pancreatic B cell hyperplasia in the child
and may cause hypoglycemia in the newborn.
c. Both hyperglycemia and hypoglycemia in early pregnancy are teratogenic.
b. Maternal hyperglycemia causes pancreatic B cell hyperplasia in the child
and may cause hypoglycemia in the newborn.
59
Why is diabetes in pregnancy a threat to the child?
a. due to the presence of glycemia
b. due to a higher concentration of insulin in the mother
c. due to a lower concentration of growth hormone in the mother
a. due to the presence of glycemia
60
Which pregnant women have a higher risk of developing malformations in the child?
a. those with frequent hypoglycemia
b. those with high HbA1c
c. those with a high daily dose of insulin
b. those with high HbA1c
61
When do malformations occur during embryonic development?
a. in the first 8 weeks
b. between the 20th and 30th week
c. between 10 and 15 weeks
a. in the first 8 weeks
62
Does pregnancy increase the risk of hypoglycemia in the first few weeks of pregnancy?
a. Yes
b. no
a. Yes
63
Does pregnancy increase the risk of progression of microvascular chronic complications of
DM?
a. Yes
b. no
a. Yes
64
Why is it necessary to add folic acid before and during pregnancy?
a. to prevent hypertension in pregnancy
b. to prevent fetal growth retardation
c. to prevent spina bifida
c. to prevent spina bifida
65
The way we look for pregnant women with pathological glycemia:
a. screening
a. screening
66
Hyperglycemia in the mother can cause hypoglycemia/hyperglicemia in a newborn.
hypoglicemia
67
The most characteristic malformation in mothers with DM type 1:
a. caudal regression.
a. caudal regression.
68
Method of delivery, which is more common in patients with hyperglycemia in pregnancy:
a. Caesarean section.
a. Caesarean section.
69
Part of the body of the fetus, the extent of which most reflects the harmful consequences of hyperglycemia:
a.belly.
a.belly.
70
The most common cause of death of a pregnant woman with long-lasting diabetes is
-acute
myocardial infarction.
-acute
myocardial infarction.
71
Which medicinesthey are not insulin secretagogues?
a. sulfonylurea
b. meglitinides
c. metformin
d. DPP-4 inhibitors
e. SGLT-2 inhibitors
f. acarbose
g. thiazolidinedione
c. metformin
d. DPP-4 inhibitors
e. SGLT-2 inhibitors
f. acarbose
g. thiazolidinedione
72
When is metformin contraindicated?
a. after an acute heart attack
b. low oGF values
c. high oGF values
d. in obese people
e. in skinny people people
a. after an acute heart attack
b. low oGF values
73
Correct statement about metformin:
a. first choice for type 2 diabetes
b. has severe side effects, therefore very rarely indicated
c. it is used with benefit in patients with type 1 diabetes
d. GIT side effects manifest as ulcer disease
a. first choice for type 2 diabetes
74
How do we regulate glycemia in a person who does not eat or drink per os:
a. rapid-acting insulin sc
b. short-acting insulin is administered via an insulin pump
c. IV insulin boluses are administered.
b. short-acting insulin is administered via an insulin pump
75
Which of the following should we consider when choosing antidiabetic therapy?
a. The effectiveness of the drug
b. Risk of hypoglycemia
c. Body weight
d. Side effects of the drug
e. The price of the drug
All of them
76
Medicines from the group of sulfonylureas can be combined with:
a. Insuline
b. DPP-4 inhibitors
c. Metformin
d. To all of the above
e. None of the above
d. To all of the above
77
When introducing insulin therapy, we calculate the approximate initial daily dose based
on:
a. BMI
b. Fasting and postprandial plasma glucose concentrations
c. Body weight
d. Carbohydrate content in food
e. Prior oral therapies
c. Body weight
78
Which of the listed insulin preparations doesn't belongs to insulin analogues?
a. Lispro
b. Apidra
c. NPH
d. Aspart
e. Glargine
c. NPH
79
The most common side effect of insulin treatment is
a. local lipodystrophy
b. hypersensitivity reaction
c. hypoglycemia
d. insulin edema
e. hirsutism
c. hypoglycemia
80
Stimulators of insulin secretion are the following drugs:
a. metformin
b. sulfonylurea
c. acarbose
d. methylprednisolone
b. sulfonylurea
81
During surgery, a patient with diabetes treated at home with sulfonylurea can
receive:
a. sulfonylurea subcutaneously
b. sulfonylurea intravenously
c. insulin subcutaneously
d. insulin intravenously
e. should not receive any therapy to avoid unrecognized hypoglycemia
d. insulin intravenously
82
Metformin can cause lactic acidosis in a patient with:
a. severe ischemic heart disease
b. advanced chronic kidney disease
c. advanced chronic liver disease
d. severe chronic obstructive pulmonary disease
e. all the listed diseases
b. advanced chronic kidney disease
83
The most common complication of metformin treatment is:
a. lactic acidosis
b. arterial hypertension
c. gynecomastia
d. deterioration of kidney function
e. diarrhea
e. diarrhea
84
Metformin:
a. is known for frequent life-threatening side effects
b. is the drug with the least side effects for the treatment of type 2 diabetes
c. causes kidney failure
d. is excreted mainly through the liver
e. no answer is correct
b. is the drug with the least side effects for the treatment of type 2 diabetes
85
Metformin:
a. is the drug of first choice for the treatment of type 2 diabetes
b. due to numerous side effects, we decide to introduce it only in a selected
patient population
c. due to dangerous side effects and a narrow therapeutic window, its concentration
in the blood is regularly monitored
d. it is also used with benefit in patients with type 1 diabetes
e. gastrointestinal side effects often lead to upper gastrointestinal ulcers
a. is the drug of first choice for the treatment of type 2 diabetes
86
Medicines from the group of sulfonylureas can be combined with:
a. insulinoma
b. acarbose
c. metformin
d. with all of the above
e. with none of the above
d. with all of the above
87
The normal functioning of the pancreas in diabetes is best mimicked by treatment
with a combination of:
a. two intermediate-acting insulins
b. human short-acting insulin and ultra-short-acting insulin
c. short-acting and medium- to long-acting insulin
d. intermediate- and long-acting insulin
e. oral therapies with ultrashort-acting insulin
c. short-acting and medium- to long-acting insulin
88
Hypersensitivity to insulin:
a. is a very rare complication of insulin treatment
b. is a very common complication of insulin treatment
c. it is most often manifested as a local reaction
d. most often manifests as a systemic reaction
e. it is more common in obese patients
a. is a very rare complication of insulin treatment
c. it is most often manifested as a local reaction
89
Insulin edema:
a. occur rarely with insulin treatment
b. often occur during insulin treatment
c. most of the time no treatment is necessary
d. In most cases, several days of aggressive treatment with a diuretic is required, so
patients are usually hospitalized
e. it is a direct effect of insulin that causes sodium retention in the body.
a. occur rarely with insulin treatment
c. most of the time no treatment is necessary
e. it is a direct effect of insulin that causes sodium retention in the body.
90
Antihypertensives that worsen glucose tolerance are:
a. thiazide diuretics
b. alpha receptor blockers
c. angiotensin receptor antagonists
d. calcium antagonists
e. angiotensin converting enzyme inhibitors
a. thiazide diuretics
91
Sulfonylureas:
a. they do not cause severe hypoglycemia
b. they work by reducing insulin resistance
c. stimulate the production of insulin
d. stimulate the exocytosis of insulin from the pancreas
e. are safe drugs, even in chronic kidney disease
d. stimulate the exocytosis of insulin from the pancreas
92
Sulfonylureas:
a. they can be safely used to treat gestational diabetes
b. may cause hypoglycemia
c. they can be used in both type 1 and type 2 diabetes
d. they have frequent side effects and are therefore very rarely used in treatment
e. it is necessary to regularly monitor drug levels in plasma
b. may cause hypoglycemia
93
Hypoglycemia with sulfonylurea:
a. usually requires hospitalization
b. the most dangerous are preparations with a short-term but intense effect
c. they are common in kidney failure
d. in case of diarrhea or vomiting or fasting, sulfonylureas are not taken for
fear of hypoglycemia
a. usually requires hospitalization
c. they are common in kidney failure
d. in case of diarrhea or vomiting or fasting, sulfonylureas are not taken for
fear of hypoglycemia
94
Metformin is a widely used drug, but it is contraindicated in:
a. extensive ischemia of the lower extremities
b. chronic kidney disease
c. severe liver damage
d. severe anemia
e. frequent severe asthmatic attacks
All of them
95
The most dangerous side effect of sulfonylurea is:
a. renal failure
b. acute myocardial infarction
c. liver failure
d. hypoglycemia
e. allergy
d. hypoglycemia
96
What is the concentration of insulin in the preparations available in Slovenia:
a. 1 U/ml
b. 4 U/ml
c. 40 U/ml
d. 100 U/ml
e. 400 U/ml
d. 100 U/ml
97
The following applies to the treatment of diabetes with an insulin pump:
a. we recommend it especially to young patients
b. it is recommended especially for patients with type 2 diabetes
c. awareness of hypoglycemia is a necessary condition for treatment
d. increases the risk of ketoacidosis
e. we recommend it to all pregnant women with diabetes
d. increases the risk of ketoacidosis
98
The following applies to the treatment of diabetes with an insulin pump:
a. It is contraindicated in infants
b. The pump is already able to advise the patient on glycemic control
c. it involves continuous intravenous administration of small amounts of insulin
d. it is suitable for the application of prandial, but not correction doses of insulin
e. compared to injectors, there is a lower risk of hyperglycemia
b. The pump is already able to advise the patient on glycemic control
99
Insulin treatment:
a. in type 2 diabetes it is only required exceptionally
b. we introduce it exclusively in hospitals
c. the basic dose of insulin in type 1 diabetes is 0.6-0.8 U/kg body weight
d. with biphasic insulins, as a rule, glycemia is regulated more precisely than with basal
and prandial insulins
e. in combination with oral therapy is contraindicated
c. the basic dose of insulin in type 1 diabetes is 0.6-0.8 U/kg body weight
100
A basal-bolus insulin regimen means that the patient uses
a. one application of biphasic insulin at breakfast and one application at dinner
b. intermediate-acting insulin at bedtime with concomitant oral therapy
c. three applications of biphasic insulin daily
d. long-acting or intermediate-acting insulin to cover basal needs and shortacting or ultra-short-acting insulin at each meal
d. long-acting or intermediate-acting insulin to cover basal needs and shortacting or ultra-short-acting insulin at each meal
101
It is most important to prevent chronic complications of diabetes
a. multifactorial treatment
b. treatment of dyslipidemia
c. treatment of arterial hypertension
d. treatment of elevated glycemia
a. multifactorial treatment
102
To cover the insulin needs of one meal, the most appropriate insulin
a. an ultrashort-acting insulin analogue
b. short-acting human insulin
c. long-acting insulin analogue
d. biphasic insulin
a. an ultrashort-acting insulin analogue
103
A conventional insulin regimen is:
a. NPH insulin morning and evening short-acting after meals
b. insulin with a sulfonylurea
c. insulin in the morning and in the evening
d. insulin in combination with metformin
c. insulin in the morning and in the evening
104
Which distribution of insulins is the most important from a clinical point of view?
a. by operating time (short-acting, long-acting)
b. after filling (vials, carpules, pre-filled injectors)
c. by origin (animal, biosynthetic)
d. according to the concentration of the preparation (100 U/ml, 40 U/ml)
a. by operating time (short-acting, long-acting)
105
Which of the following patients would you start a basal-bolus insulin regimen?
a. 77-year-old retired mathematics professor, SB 2 17 years, HbA1c 9.8% on Glucovance 500/5
mg 3x 1tbl, visually impaired due to macular degeneration and therefore no longer has a
driver's license, lives with his wife, who also cooks for him. He spends the summer with his
wife in a caravan on the coast.
b. 50-year-old commercial woman, DM type 2 for five years, HbA1c 7.9% with
Novonorm 3x 4 mg and Aglurab 3x 850 mg, she goes on a business trip abroad
at least once a month, usually on a long trip on annual leave
c. 84-year-old retired nurse, DM type 2 for 25 years, with Glurenorm and Aglurab HbA1c
12%. He lives in DSO, goes for an hour's walk every day, once a year for a week in
Strunjan. He takes the therapy in the DSO independently, without the help of the
home staff.
d. 71-year-old retired seamstress, type 2 diabetes for 15 years, last five years on
combined therapy with Diaprel and Aglurab, HbA1c 9%. She lives with her husband,
cooks herself, meals more or less at the same time every day, twice a year she and
her husband go to the spa for a week.
b. 50-year-old commercial woman, DM type 2 for five years, HbA1c 7.9% with
Novonorm 3x 4 mg and Aglurab 3x 850 mg, she goes on a business trip abroad
at least once a month, usually on a long trip on annual leave
106
On the basis of which parameter is the initial dose of insulin determined?
a. according to blood sugar before bed
b. according to fasting blood sugar
c. according to body weight
d. according to the number of food portions and their quantitative and qualitative composition
c. according to body weight
107
The calculated daily energy requirement is generally higher in diabetic patients
who are not treated with insulin than in people without diabetes
a. True
b. It's not true
b. It's not true
108
Sulfonylurea preparations are the first therapy of choice for obese patients
a. True
b. It's not true
b. It's not true
109
To cover the insulin needs of one meal, the most appropriate insulin
a. short-acting human insulin
b. long-acting insulin analogue
c. an ultrashort-acting insulin analogue
d. biphasic insulin
c. an ultrashort-acting insulin analogue
110
How should patients adjust insulin doses themselves?
a. patients should not change the doses themselves, but should give themselves the doses ordered
by the doctor during the outpatient check-up
b. patients should not change the doses themselves, except when not eating or if they
skip a meal in preparation for an examination (US, gastroscopy, etc.) - in this case,
they should skip the dose.
c. based on the currently measured value according to the principle of sliding doses: for a low
value, the dose is reduced or omitted, for a high value, the dose is increased to a
maximum of double the initial
d. based on the dynamics of glycemia in the daily profile according to the cause-effect
principle
d. based on the dynamics of glycemia in the daily profile according to the cause-effect
principle
111
When treating with metformin, we fear the most:
a. hypoglycemia
b. exacerbation of renal impairment
c. ketoacidosis
d. lactic acidosis
e. obesity
d. lactic acidosis
112
Acarbose:
a. contraindication is chronic inflammatory bowel disease
b. it can be used to treat all types of diabetes, including gestational diabetes
c. practically no side effects
d. in monotherapy, it can effectively control glycemia in the long term
e. affects primarily basal glycemia
a. contraindication is chronic inflammatory bowel disease
113
Screening test for diabetic retinopathy:
a. Imaging of the fundus camera
b. Laboratory monitoring
c. Pinhole inspection
d. Visus, fundus and campus examination
e. Vascular imaging with fluorescence technique
a. Imaging of the fundus camera
114
What is the basic examination to assess the arterial circulation of the legs?
a. Sensation of hot/cold
b. Palpation of pulses a. dorsalis pedis and a. tibialis posterior
c. Measurement of perfusion pressures at the ankle and calculation of the ankle index
d. Angiography
e. Oximetry
b. Palpation of pulses a. dorsalis pedis and a. tibialis posterior
115
The oral glucose tolerance test is performed:
a. after three days of a proper diabetic diet
b. after 8-12 hours of starvation
c. after breakfast
d. the day before the test, avoid foods containing carbohydrates and saturated
fatty acids
b. after 8-12 hours of starvation
116
Determination of microalbuminuria:
a. it is determined only if macroalbuminuria is detected
b. the result is reliable only if it is determined in the collected 24-hour urine
c. with normal excretion of albumin in the urine, the examination is repeated every 5 years
d. none of the above
d. none of the above
117
The only accurate way to diagnose diabetes is:
a. determination of fasting glucose
b. oral glucose tolerance test
c. the presence of clinical symptoms and signs of hyperglycemia
a. determination of fasting glucose
b. oral glucose tolerance test
118
Choose the correct statements.
a. The borderline values between the pathological and normal range of glycemia were determined
according to the occurrence of microangiopathy.
b. The borderline values between the pathological and normal range of glycemia were determined
according to the occurrence of macroangiopathy.
c. The standard way to diagnose diabetes is to measure fasting blood
glucose.
d. People with impaired glucose tolerance are characterized by a higher risk of
developing microangiopathic complications.
A,c,d
119
In an asymptomatic person, it is sufficient for the diagnosis of diabetes
a. two fasting glucose measurements of 7.0 mmol/l or more on two different days
b. one fasting glucose measurement of 7.0 mmol/l or more and glycosuria
c. one fasting glucose measurement of 7.0 mmol/l or more
d. one measurement with a convenient glucose meter that patients use at home
(glucometer) 7.0 mmol/l or more
a. two fasting glucose measurements of 7.0 mmol/l or more on two different days
120
Impaired glucose tolerance is tested:
a. Fasting
b. 120 min after OGTT
c. After breakfast
d. Immediately after the glucose load
b. 120 min after OGTT
121
Choose the correct statements:
a. With DM1, we test for chronic complications immediately upon diagnosis
b. In DM1, we test for chronic complications 5 years after diagnosis
c. With DM2, we test for chronic complications immediately upon diagnosis
d. All diabetic patients are tested for chronic complications every year
B,C,D
122
An OGTT is performed on a person and the results are obtained: immediately after drinking the drink, the glucose is
6.8 mmol/l, after 120 minutes the glucose is 9.8 mmol/l. What is it?
a. impaired glucose tolerance,
b. borderline basal glycemia
c. Diabetes
d. he is healthy
a. impaired glucose tolerance,
b. borderline basal glycemia
123
A 42-year-old patient has a fasting blood glucose value of 4.5 mmol/l after an oral glucose
tolerance test, and 10.0 mmol/l in the 120th minute. The patient most likely has:
a. Limit basal glycemia
b. Diabetes
c. Normoglycemia
d. Impaired glucose tolerance
e. Hereditary glycogenosis
d. Impaired glucose tolerance
124
An 80-year-old man's fasting blood sugar was measured at 7.5 and 7.4 mmol/l on two
different occasions. Circle the most correct statement
a. The gentleman is normoglycemic.
b. The gentleman has borderline basal glycemia.
c. The gentleman has impaired glucose tolerance.
d. The gentleman has senile diabetes that does not require further action.
e. The gentleman has diabetes.
e. The gentleman has diabetes.
125
Assessment of possible chronic complications of diabetes is carried out:
a. when type 1 diabetes is diagnosed
b. five years after being diagnosed with type 1 diabetes
c. five years after being diagnosed with type 2 diabetes
d. every year, regardless of the type of diabetes
e. only with pronounced symptoms of peripheral organ damage, since complications cannot be
cured, we can only alleviate the symptoms
b. five years after being diagnosed with type 1 diabetes
126
How to test important defense/basal sensation in diabetics
a. the screening test for its detection is the Semmes-Weinstein
monofilament test
a. the screening test for its detection is the Semmes-Weinstein
monofilament test
127
Diabetic ketoacidosis occurs more often in:
a. to a demented patient
b. to a young patient
c. to an overfed patient
d. to a normally fed patient
e. malnourished patient
b. to a young patient
d. to a normally fed patient
127
The most common triggering factor for diabetic ketoacidosis is:
a. inadequate insulin dosage
b. discontinuation of insulin treatment
c. newly diagnosed diabetes
d. infection
e. treatment with corticosteroids
d. infection
128
In the treatment of diabetic aketotic hyperosmolar syndrome, in the first hour in
the absence of significant heart failure, the correct rate of replacement of crystalloid
solutions
a. 50 ml
b. 100 ml
c. 200 ml
d. 1000 ml
e. 2000 ml.
d. 1000 ml
129
Treatment of acute complications of diabetes requires:
a. insulin replacement
b. fluid replacement
c. electrolyte replacement
d. correction of acidosis
e. prevention of thromboembolism
All of them
130
Which symptoms are characteristic of DAHS?
a. abdominal pain
b. hypothermia
c. very high blood glucose levels
d. dehydration
e. moderately increased nitrogen retention
b. hypothermia
c. very high blood glucose levels
d. dehydration
131
The following applies to DAHS:
a. he is treated with sc long-acting insulin
b. he is treated with sc short-acting insulin
c. it is treated with long-acting insulin iv
d. it is treated with boluses of short-acting insulin IV
e. it is treated with an infusion of short-acting insulin
e. it is treated with an infusion of short-acting insulin
132
The following applies to ketoacidosis:
a. is the result of unrestrained lipolysis
b. is the result of unrestrained gluconeogenesis
c. does not occur in type 2 diabetes
d. the leading metabolic process is anabolism
a. is the result of unrestrained lipolysis
132
Diabetic autonomic neuropathy is characterized by:
a. occurs with more than 20 years of diabetes duration
b. associated with high mortality
c. is one of the most studied complications of diabetes
d. the diagnosis is made on the basis of a neurological physical examination
e. the screening test for its detection is the Semmes-Weinstein monofilament
test
b. associated with high mortality
d. the diagnosis is made on the basis of a neurological physical examination
133
What is autonomic diabetic neuropathy?
a. Appears early
b. Death due to rhythm disturbances
c. Erectile dysfunction and nocturnal diarrhea
d. Orostatic hypotension and chronic bradycardia
e. Diabetic neuropathy can only be determined by excluding other causes
b. Death due to rhythm disturbances
c. Erectile dysfunction and nocturnal diarrhea
d. Orostatic hypotension and chronic bradycardia
e. Diabetic neuropathy can only be determined by excluding other causes
134
What isn't considered an ischemic leg ulcer in diabetes?
a. It is dry necrosis
b. Hyperkeratotic margin
c. Ulcer under the 3rd metatarsal
d. Ulcer on the contact surface of the 4th and 5th finger
e. Anthills at rest
f. Pain in the limb after walking 500 m
b. Hyperkeratotic margin
c. Ulcer under the 3rd metatarsal
e. Anthills at rest
135
Progression of diabetic retinopathy doesn't speed up:
a. arterial hypertension
b. acute myocardial infarction
c. renal failure
d. rapid lowering of blood glucose
e. pregnancy
b. acute myocardial infarction
d. rapid lowering of blood glucose
136
Diabetic retinopathy
a. is due to angiopathy
b. is due to neuropathy
c. we look for it in the discovery of type 1 diabetes
d. we look for it in the discovery of type 2 diabetes
a. is due to angiopathy
d. we look for it in the discovery of type 2 diabetes
137
Diabetic nephropathy. Circle the wrong answer:
a. almost all patients have diabetic retinopathy
b. before starting treatment, we need accurate imaging and histological
diagnosis
c. in patients with type 1 diabetes, we start determining the excretion of albumin in
the urine as a screening test only 5 years after the diagnosis of diabetes, and in
patients with type 2 diabetes immediately after the diagnosis of diabetes
d. well-controlled diabetes can play a role in slowing down the disease
e. smoking directly affects the deterioration of kidney function
b. before starting treatment, we need accurate imaging and histological
diagnosis
138
Circle the correct statements regarding diabetic kidney disease.
a. the appearance of microalbuminuria is a sure sign of early diabetic
kidney disease in type 1 diabetes
b. the appearance of microalbuminuria is a reliable sign of early diabetic kidney
disease in type 2 diabetes
c. proteinuria is a basic sign of diabetic kidney disease
d. hematuria is the basic sign of diabetic kidney disease
a. the appearance of microalbuminuria is a sure sign of early diabetic
kidney disease in type 1 diabetes
c. proteinuria is a basic sign of diabetic kidney disease
139
What type of nerve damageit is not characteristic of diabetes?
a. spastic hemiparesis
b. carpal tunnel syndrome
c. autonomic neuropathy
d. symmetrical sensorimotor neuropathy
e. symmetrical proximal neuropathy of the lower limbs
a. spastic hemiparesis
140
The most common cause of death in a diabetic patient is:
a. diabetic ketoacidosis
b. diabetic kidney disease
c. diabetic polyneuropathy
d. macroangiopathy
e. malignant
d. macroangiopathy
141
Circle the specific complication of diabetes:
a. acute myocardial infarction
b. diabetic cardiomyopathy
c. diabetic nephropathy
d. Charcot foot
e. cerebrovascular insult
c. diabetic nephropathy
142
The diagnosis of diabetic kidney disease is very likely if
a. diabetes lasts more than 5 years
b. diabetic retinopathy is present
c. constant proteinuria is more than 0.5 g/day
d. arterial hypertension is present
e. frequent urinary tract infections are absent
A,B,C,E
143
Circle the correct statements regarding diabetic kidney disease.
a. the appearance of microalbuminuria is a very likely sign of early diabetic
kidney disease in type 2 diabetes
b. proteinuria is a common sign of diabetic kidney disease
c. hematuria is a common sign of diabetic kidney disease
d. patients with hematuria have the shortest survival
b. proteinuria is a common sign of diabetic kidney disease
144
Autonomic neuropathy in diabetes.
a. half of patients with autonomic neuropathy die within the first year of
diagnosis
b. autonomic disorders include erectile dysfunction and nocturnal diarrhea
c. patients may have persistent bradycardia or postural hypotension
d. patients with this complication are most at risk of sudden heart rhythm disturbances
B,C,D
145
The peculiarity of coronary disease in diabetes is:
a. the absence of typical changes in the ECG
b. absence of typical chest pain
c. the absence of an increase in heart muscle breakdown enzymes
d. poorer response to nitroglycerin treatment
e. poorer response to beta-blocker therapy
b. absence of typical chest pain
146
Circle the correct statements regarding the macrovascular complications of diabetes
a. women develop them more often than men
b. due to the high risk of macrovascular complications, antiplatelet protection is
recommended for all patients with diabetes
c. the probability of coronary heart disease is higher in the presence of renal
involvement
d. atherosclerosis covers a larger area of the arterial vessel as well as vessels of
smaller caliber
c. the probability of coronary heart disease is higher in the presence of renal
involvement
d. atherosclerosis covers a larger area of the arterial vessel as well as vessels of
smaller caliber
147
The most common among diabetic neuropathies is:
a. autonomic neuropathy
b. paresis n. facialis
c. caude equine syndrome
d. entrapment syndrome n. medianus
e. distal symmetrical peripheral polyneuropathy
e. distal symmetrical peripheral polyneuropathy
148
Mediocalcinosis
a. the measured pressures on the leg are higher than the normal value
b. causes dry tissue necrosis
c. occludes the vessel
d. usually the pressures measured in the lower extremities are lower than those in the upper
extremities
e. none of the above
a. the measured pressures on the leg are higher than the normal value
149
Macrovascular complications:
a. are specific for diabetes
b. are more common in type 2 diabetes
c. they never develop in type 1 diabetes
b. are more common in type 2 diabetes
150
How do we most effectively prevent complications on the legs of diabetic patients, gangrene
and amputations?
a. We examine the feet of all patients at regular intervals, regardless of whether they
report problems or not
b. We examine the feet of patients with poorly controlled diabetes
c. We examine the legs of patients who say that their legs hurt
d. We examine the legs of patients who say they have an ulcer on their leg
e. We examine the legs
a. We examine the feet of all patients at regular intervals, regardless of whether they
report problems or not
151
Which of the following is characteristic of an ischemic ulcer?
a. Pink skin
b. Fibrin coatings and necrosis at the base of the ulcer, desquamated epithelium at the edge
c. Painless ulcer on the sole
d. Profuse, hard hyperkeratosis at the edge of the ulcer
b. Fibrin coatings and necrosis at the base of the ulcer, desquamated epithelium at the edge
152
Diabetic foot ulcers are usually found on the surface
a. anaerobes
b. streptococci
c. staphylococci
d. enterobacteria
c. staphylococci
153
A man after an acute myocardial infarction has a glucose level of 17 mmol/l. What do we do?
a. metformin before meals and a sulfonylurea in the evening
b. another combination with antiglycemic drugs
c. basal-prandial scheme
d. ultrashort-acting insulins before each meal
e. ultrashort insulins before each meal and at 24 hours
c. basal-prandial scheme
154
A man has diabetes. The other day he was in the hills and had his mountain boots on all day.
He had an ulcer under his right little finger. He has no fever, but has all the features of a
neuropathic ulcer. Next to it, there is also redness, which is already on the other side of the
foot. What do we do?
a. wound toilet
b. we take an X-ray of the foot
c. laboratory (differential blood count, CRP...)
d. we prescribe an antibiotic immediately
e. we give an antibiotic only after we get an antibiogram
a. wound toilet
d. we prescribe an antibiotic immediately
155
A 42-year-old (otherwise healthy) gentleman comes for a check-up to a selected doctor due to a
14-day-long feeling of unwellness. Describes increased thirst, frequent urination, visual and
memory disturbances, severe weakness. In the last month, he unintentionally lost weight by 6 kg.
In the laboratory results in the blood, Hb 145 g/l, leukocytes 7.0 x 109/l, platelets 250 x 109/l,
glucose 17 mmol/l , creatinine 80 micromol/l, sodium, potassium, chlorine, pH , pO2, pCO2,
bicarbonate are unremarkable. In the urineglucose +++ , proteins +,ketones +++ . The patient most
likely has:
a. SIADH
b. type 1 diabetes
c. type 2 diabetes
d. congenital glycogenosis
e. dilutional hyponatremia
b. type 1 diabetes
156
A 35-year-old lady, who is otherwise healthy, is found to have elevated sugar (10.3 mmol/l) during
a systematic fasting examination. He does not have polyuria, polydipsia or any other health
problems. What does it have and how would you act?
a. Limit basal glycemia
b. Impaired glucose tolerance
c. On the next day, we take her blood again, the results decide whether to carry out an OGTT
d. We send her to OGTT
e. We tell the lady that she has diabetes and start therapy
c. On the next day, we take her blood again, the results decide whether to carry out an OGTT
157
A 23-year-old patient, thirsty and polyuric for a week, has been vomiting intensely for the past 24 hours. What
is the working diagnosis upon admission to IPP?
a. Type 2 diabetes
b. Acute pancreatitis
c. Type 1 diabetes with ketoacidosis
d. Diabetes insipidus
e. Acute gastroenterocolitis
c. Type 1 diabetes with ketoacidosis
158
A 52-year-old patient with arterial hypertension and elevated cholesterol noticed that he was very
thirsty in the last 14 days, and he also drank 5 liters of Coca-Cola a day. In addition, he passed
urine 10 times a day, at least 2 times at night. He could no longer clearly see the subtitles on the
TV, he was very tired and weak. He did not come to the chosen doctor until the afternoon, who
sent him to the laboratory, where the blood glucose level was determined to be 16.3 mmol/l. What
is the most appropriate next step for the selected physician?
a. He tells the patient that he has diabetes and starts therapy
b. He tells the patient that he probably has diabetes, but that the elevated blood
glucose should be confirmed on another fasting day.
c. He tells the patient that he probably has diabetes, but a fasting oral glucose
tolerance test must be performed to make an accurate diagnosis.
d. He tells the patient that he probably has diabetes, but to confirm definitively, he
needs to have a glucose test on another day, at which time the blood glucose
must be in the diagnostic range.
e. He tells the patient not to worry about this glucose value, as the laboratory in
question always comes with slightly elevated glucose values and is probably
unrealistic.
a. He tells the patient that he has diabetes and starts therapy
159
A 60-year-old lady, who is otherwise perfectly healthy, measures her blood glucose value of
18.1 mmol/l on a friend's glucometer after lunch at her granddaughter's birthday party.
She is completely shaken by this and goes to the doctor of her choice the next day. What are
the best next steps for the chosen doctor to take?
a. The lady is referred for fasting blood glucose measurement the next day. Since the fasting blood
glucose is 9.0 mmol/l, he explains to her that she has SB and initiates treatment.
b. He refers the lady to have her fasting blood glucose measured on two different days. Once the
value is 9.0, the second time is 8.1 mmol/l. The lady explains that she probably doesn't have SB
as her blood sugar is trending lower… and with the diet it will probably be in the normal range
soon.
c. The lady is referred for fasting blood glucose measurement the next day. Since her
fasting blood glucose is 9.0 mmol/l, he gives her a referral for an oral glucose
tolerance test to make sure with a precise method whether SB is really present.
d. He refers the lady the next day to measure fasting blood glucose and urine glucose.
Blood glucose is ? mmol/l, urine is +++. Because of the two pathological results, he
tells her that she has SB and introduces her…
e. He refers the lady to have her fasting blood glucose measured on two different days.
Once the value is 9.0, the other 8.1 mmol/l. He explains to the lady that she has SB
and starts her treatment
e. He refers the lady to have her fasting blood glucose measured on two different days.
Once the value is 9.0, the other 8.1 mmol/l. He explains to the lady that she has SB
and starts her treatment
160
A 50-year-old patient is brought to the emergency department with a disturbance of consciousness -
soporium. Respiratory frequency 24/min, fr. heartbeat 116/min, body temperature 35.7 degrees. C.
From the laboratory findings, we understand:blood glucose 22 mmol/l , CRP 5, urea 16.5, creatinine 130,
blood pH 7.1, pO2 14.0 kPa, pCO2 4.6 kPa,anion gap 15 ,urine ketones positive.
a. exacerbation of asthma
b. acute myocardial infarction
c. diabetic ketoacidosis
d. DAHS
e. sepsis
c. diabetic ketoacidosis
161
A patient who states that he has been very tired, thirsty and urinates frequently for several weeks,
during an outpatient examination in the laboratory, we measure KS of 13.4 mmol/l. What is the correct
action?
a. the patient is told that he has diabetes.
b. for a definitive diagnosis, it is necessary to check whether he was fasting when the blood was taken
c. another fasting glucose measurement is required for a definitive diagnosis
d. a standard tolerance test is required for a definitive diagnosis
e. for a definitive diagnosis, it is necessary to perform an ultrasound of the abdomen with an examination
of the pancreas
a. the patient is told that he has diabetes.
162
A 55-year-old patient, who has been treated for type 2 diabetes for 8 years, had a blood
pressure of 150/90 mmHg three times in the clinic. He has no known complications of
diabetes. As a drug of first choice, we use:
a. angiotensin converting enzyme inhibitor
b. indapamide
c. beta-blocker
d. an alpha-blocker
e. calcium antagonist
a. angiotensin converting enzyme inhibitor
163
A 42-year-old patient has a fasting blood glucose value of 4.5 mmol/l after an oral glucose
tolerance test, and 10.0 mmol/l in the 120th minute. The patient most likely has:
a. normoglycemia
b. diabetes
c. borderline basal glycemia
d. impaired glucose tolerance
e. hereditary glycogenosis
d. impaired glucose tolerance
164
On examination, a man who has been healthy until now is short of breath, breathes quickly and deeply, his
face is red, he has a pain in the spoon, he is dehydrated, he has been going to the water a lot for a week,
during this time he has lost 8 kg, the last day he feels sick and urges to vomit, blood pressure is 120/85 mmHg.
What for example expect in his lab results?
a. glucose 5.6 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/l
b. glucose 11.1 mmol/l, ketonuria 0, arterial blood pH 7.25, potassium 4.5 mmol/l
c. glucose 22.1 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/l
d. glucose 22.1 mmol/l, ketonuria 0, arterial blood pH 7.46, potassium 4.5 mmol/l
c. glucose 22.1 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/l
165
A previously healthy man was short of breath during the examination, breathing quickly and deeply,
reddened in the face, pain in the spoon, dehydrated, he has been going to the water a lot for a week,
during this time he lost 8 kg, the last day he felt sick and urges to vomit, blood pressure is 120/85
mmHg. Findings: glucose 22.1 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/L. You
admit him to the hospital to continue the treatment. How do you start treating it?
a. 500 ml of saline, flowing at a rate of 100 ml/h
b. 500 ml of physiological solution with the addition of 8 U of Actrapida and 20 mEq of KCl, run for
one hour, then control of glucose and potassium
c. 500 ml of 5% glucose in saline with 6 U of Actrapida, flowing at a rate of 100 ml/h
d. Actrapid 8E subcutaneously, 500 ml saline with the addition of 20 mEq KCl
b. 500 ml of physiological solution with the addition of 8 U of Actrapida and 20 mEq of KCl, run for
one hour, then control of glucose and potassium
166
A middle-aged female patient has type 2 diabetes, for which she receives biphasic insulin twice a
day, she became ill with signs of bacterial pneumonia, which was confirmed in the emergency
internist clinic. She is hemodynamically stable, does not need supplemental oxygen, in the selfmonitoring diary of the last days, her glycemia is higher than usual, around 12.0 mmol/l in the
morning, and from 15.0 to 20.0 mmol/l during the day. What is the correct action?
a. antibiotic, hospitalization
b. antibiotic, discharge to home care, increase both doses of insulin, regular BP
measurements and self-titration of insulin dose, follow-up with general
practitioner/family doctor according to pneumonia and glycemic status
c. antibiotic, discharge to home care without additional measures
d. antibiotic, discharge to home care, check-up with a diabetologist in 1 month
b. antibiotic, discharge to home care, increase both doses of insulin, regular BP
measurements and self-titration of insulin dose, follow-up with general
practitioner/family doctor according to pneumonia and glycemic status
167
A patient is receiving metformin and an insulin secretagogue, both in the maximum permitted
dose. He takes medicine regularly. This morning he took them as usual, ate a small breakfast, then
skipped lunch due to a dentist appointment. At the dentist, he became confused and sweaty
already in the waiting room. His blood glucose was measured. What result do you expect and what
is the measure?
a. glucose 2.5 mmol/l, it is hypoglycemia, the patient receives an IV infusion of 20-50%
glucose until the normalization of consciousness or glycemia over 10 mmol/l,
hospitalization will be necessary
b. glucose 15.6 mmol/l, the patient should go home, insulin treatment will be
required
c. glucose 5.6 mmol/l, the patient is afraid, he can go home
d. glucose 2.5 mmol/l, it is hypoglycemia, the patient drinks 2 dl of tea with three
tablespoons of dissolved sugar, the patient can go home, buy a meter and measure
his blood sugar for the next week before each meal
a. glucose 2.5 mmol/l, it is hypoglycemia, the patient receives an IV infusion of 20-50%
glucose until the normalization of consciousness or glycemia over 10 mmol/l,
hospitalization will be necessary
168
A 68-year-old patient with long-term poorly controlled type 2 diabetes comes to the outpatient clinic
because of a fresh ulcer on the sole of the foot, under the ball of the third foot, which appeared after
walking around the mall all Saturday. He has an elevated temperature of 37.8 °C. The wound is
surrounded by a hyperkeratotic border, a small amount of serous discharge is oozing from the wound,
the surrounding area is red, and even the foot is warm to the touch. The wound doesn't hurt him.
Diagnosis: It is an ischemic ulcer.
a. True
b. It's not true
b. It's not true
169
A 23-year-old patient was brought to the IPP because of persistent vomiting lasting 24 hours,
before which he had noticed increased thirst, polyuria and general fatigue for about a week.
What is the most likely working diagnosis?
a. acute gastroenterocolitis
b. acute pancreatitis
c. newly diagnosed type 2 diabetes
d. newly diagnosed type 1 diabetes with ketoacidosis
d. newly diagnosed type 1 diabetes with ketoacidosis
170
An 80-year-old DSO patient is brought to the IPP with poor contactability, clinically
dehydrated, RR 110/65 mm Hg. Findings: glucose 45 mMol/L, urea 35, creatinine 275. How
would you start the treatment?
a. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 8 U/h
b. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 24 U/h
c. infusion of 0.9% NaCl solution 500 ml/4h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 8 U/h
d. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid, Humulin
R) 8 U sc, after one hour KS control and dose modification if necessary
a. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 8 U/h
171
. A 48-year-old woman, so far healthy and without regular drug therapy, is referred to
the triage diabetes clinic because a systematic examination at work revealed a fasting
blood sugar level of 10.3 mmol/L. At the same time, she did not feel increased thirst, was
not polyuric and did not lose weight. She smokes 10 cigarettes a day, does sedentary
work (administrator), does not play sports. On examination TV 163 cm, TT 80 kg, RR
149/95 mmHg, KS fasting 9.8 mmol/L, HbA1c 8.5%. How would you act?
a. we advise a healthy diet, regular physical activity and weight reduction and
introduce metformin
b. we advise a healthy diet, regular physical activity and weight reduction
c. the patient is referred for an OGTT, until then no therapeutic measures are
introduced
d. a sulfonylurea is introduced
e. we introduce metformin
b. we advise a healthy diet, regular physical activity and weight reduction
172
An 8-year-old patient with long-term poorly controlled type 2 diabetes comes to the clinic because of a
fresh ulcer on the sole of the foot, under the ball of the third foot, which appeared after walking around
the mall all Saturday. He has an elevated temperature of 37.8 °C. The wound is surrounded by a
hyperkeratotic border, a small amount of serous discharge is oozing from the wound, the surrounding
area is red, and even the foot is warm to the touch. The wound doesn't hurt him. What is it about?
a. ischemic ulcer
b. neuroischemic ulcer
c. neuropathic ulcer
c. neuropathic ulcer
173
A 48-year-old woman, so far healthy and without regular drug therapy, is referred to the
triage diabetes clinic because a systematic examination at work revealed a fasting blood
sugar level of 10.3 mmol/L. At the same time, she did not feel increased thirst, was not
polyuric and did not lose weight. She smokes 10 cigarettes a day, does sedentary work
(administrator), does not play sports. On examination TV 163 cm, TT 80 kg, RR 149/95 mmHg,
KS fasting 9.8 mmol/L, HbA1c 8.5%. In the diagnostic procedure, all investigations are
meaningful,except:
a. preventive foot examination
b. lipidogram
c. urea, creatinine, oGF, native urine
d. examination of the fundus of the eye
e. hemogram
e. hemogram
174
A 48-year-old woman, so far healthy and without regular drug therapy, is referred to the
triage diabetes clinic because a systematic examination at work revealed a fasting blood
sugar level of 10.3 mmol/L. At the same time, she did not feel increased thirst, was not
polyuric and did not lose weight. She smokes 10 cigarettes a day, does sedentary work
(administrator), does not play sports. On examination TV 163 cm, TT 80 kg, RR 149/95 mmHg,
KS fasting 9.8 mmol/L, HbA1c 8.5%. What is it about?
a. The patient has newly diagnosed type 2 diabetes
b. The patient has borderline basal glycemia
c. The patient probably has type 2 diabetes, but we need to do an OGTT
response to confirm
a. The patient has newly diagnosed type 2 diabetes
175
During the screening test, the patient says that he has to stop after about 100 m when
walking on a flat surface because of pain in his legs, which subsides after a short rest, and he
cannot walk uphill at all. He likes to get cold in his legs, and every little wound or injury is
extremely reluctant to heal. Type 2 diabetes is 20 years old, takes insulin, HbA1c 7.2%.
During the examination, we find a loss of protective sensitivity at 1 point on the right and at 2
points on the left foot. Foot pulses are not palpable. There are no deformations. He smokes up to
5 cigarettes a day, receives medication for high blood pressure and cholesterol. TV 181 cm, TT 80
kg. What is it about and how to act?
a. The patient has a circulatory disorder and sensory neuropathy, needs an
angiologist examination, smoking cessation, custom shoes and pain
medication
b. The patient has sensory neuropathy, he needs painkillers due to the feeling of cold
feet. He should not remove hard skin and nails himself, but should go to a pedicurist.
If his legs get cold at night, he should help himself with a hot water bottle or a
heating pad
c. The patient has a disorder of arterial circulation, it is necessary to quit smoking and be
examined by an angiologist. It is necessary to wear comfortable, soft and warm footwear
and to avoid injuries, regular self-examination of the feet
d. The patient has a disorder of arterial circulation and is at risk of developing an ulcer.
Regular foot self-examination and custom-made shoes are essential
c. The patient has a disorder of arterial circulation, it is necessary to quit smoking and be
examined by an angiologist. It is necessary to wear comfortable, soft and warm footwear
and to avoid injuries, regular self-examination of the feet
176
During a preventive examination of the legs, the patient says that he has painful spasms in the legs,
especially at night, and can walk long distances without problems. Upon examination, we find a loss of
protective sensitivity at 7 points on the right and at 9 points on the left foot, as well as an unreliable
sense of heat and cold. Foot pulses are palpable. There are no deformations. Diabetes is managed with
tablets, HbA1c is 8.0%. He regularly smokes 10-15 cigarettes a day, does not have elevated blood fats,
and his blood pressure is well controlled with a combination of two medications. TV 170 cm, TT 90 kg.
What is it about and how would you act?
a. The patient has a circulatory disorder and sensory neuropathy, needs an
angiologist examination, smoking cessation, custom shoes, pain medication, and
immediate initiation of insulin therapy
b. The patient has a disorder of arterial circulation, it is necessary to stop smoking and be examined by an
angiologist
c. The patient has sensory neuropathy and is at risk of ulceration. Regular selfexamination of the feet, smoking cessation, weight loss, strict adherence to
the principles of a healthy diet and the introduction of insulin are essential
if lifestyle changes are not sufficient.
d. The patient has sensory neuropathy and is at risk of ulceration. Regular foot selfexamination and custom-made shoes are essential
c. The patient has sensory neuropathy and is at risk of ulceration. Regular selfexamination of the feet, smoking cessation, weight loss, strict adherence to
the principles of a healthy diet and the introduction of insulin are essential
if lifestyle changes are not sufficient.
177
A 77-year-old patient with long-standing type 2 diabetes, arterial hypertension, hypercholesterolemia,
and ischemic heart disease has been being monitored in the outpatient clinic for six months due to an
ulcer under the ball of the 3rd foot on the right foot, which occurred after a day trip during which he
walked more than usual. The leg is warm, the skin is pink, the ulcer is surrounded by an abundant
hyperkeratotic rim, there is little secretion, the bottom is clean, there is no redness or swelling in the
area. The area of the ulcer does not decrease. What is it about and how would you act?
a. The patient has a neuropathic ulcer. The cause of poor healing is most likely
insufficient relief of the affected area - the patient needs a temporary shoe
or plaster slipper
b. The patient has a neuroischemic ulcer, the cause of poor healing is most likely an
infection, an antibiotic is needed
c. The patient has a neuropathic ulcer. Because healing is poor, an underlying
circulatory disorder is most likely overlooked
d. The patient undoubtedly has an ischemic ulcer, he urgently and immediately needs an examination by an
angiologist
a. The patient has a neuropathic ulcer. The cause of poor healing is most likely
insufficient relief of the affected area - the patient needs a temporary shoe
or plaster slipper
178
Data from the anamnesis and changes in the legs, which are evaluated during the
preventive examination - screening test, are listed. Which of the above is sufficient in
itself to place the patient in the most endangered category - risk group 4?
a. Loss of sensation to touch (with monofilament) and to vibration
b. He had a leg ulcer in the past
c. Absent foot pulses
d. Leg deformities – hallux valgus, clawed toes
b. He had a leg ulcer in the past
179
A 65-year-old retired auto mechanic was diagnosed with rectosigmoid cancer with metastases in the
regional lymph nodes and liver. He underwent surgery, has a stoma, started chemotherapy, after which
he vomits several times, his appetite is poor, he lost 10 kg. During treatment, newly discovered diabetes,
HbA1c 8.5%, initially treated in the hospital with a basal-bolus scheme, with glycemia in the daily profile
between 8 and 10 mmol/L. What kind of therapeutic scheme would you try to implement at home?
a. Humalog with main meals and Humulin N at bedtime
b. Humalog mix (25) morning and evening
c. Diaprel MR and Aglurab
d. only Diaprel MR
a. Humalog with main meals and Humulin N at bedtime
180
A 70-year-old female patient, who has been treated for diabetes for 15 years, for the last 6 months
with a combination of oral antidiabetics and long-acting insulin at bedtime, a long-term smoker,
comes to the clinic because of an ulcer on the lateral edge of the left heel. She attributes the
problem to the new shoes she bought a week ago and then walked around the mall in them all
afternoon. On examination, the leg is cold, the skin is thin and bluish in color, we can see a
detached epidermis on the edge of the heel, there is almost no hyperkeratosis, necrosis is visible
at the bottom of the ulcer. Foot pulses absent. There are no local or systemic signs of infection.
What is it about and how would you act?
a. The patient got a blister from new, unworn shoes, she has to stretch it on the
hoof, she should wear her old shoes for a few days, the ulcer will heal by
itself
b. The patient has a disorder of arterial circulation and necrosis at the base of the callus,
which was caused by inappropriate footwear. He needs rest and relief and an immediate
examination by an angiologist
c. The patient has sensory neuropathy, which is why she developed a blister. In order to prevent
infection, he needs an antibiotic and once a day bandage the wound with sterile gauze
d. The patient has a disorder of arterial circulation and necrosis at the base of the callus, which was
caused by inappropriate footwear. Since she has no signs of infection, we advise her to cover
the blister with sterile gauze, rest for a few days and check with her doctor if there is no
improvement within a week
b. The patient has a disorder of arterial circulation and necrosis at the base of the callus,
which was caused by inappropriate footwear. He needs rest and relief and an immediate
examination by an angiologist
181
Nesidioblastosis is:
a. functional excess insulin secretion after a carbohydrate-rich meal
b. pancreatic beta cell hyperplasia
c. hypoglycemia induced by increased secretion of IGF-1 and IGF-2
d. a subtype of alimentary hypoglycemia
e. hypoglycemic syndrome caused by pituitary failure
b. pancreatic beta cell hyperplasia
182
Insulin counterregulatory hormones are:
a. glucagon
b. growth hormone
c. cortisol
d. adrenaline
All of them
183
The following applies to diabetes:
a. antihypertensive therapy is not so important in diabetics, as it is more
important to correct blood sugar
b. if hypoglycemia occurs, we do not adjust the medication doses, as it is important to
reach the target pressure
c. diabetics more often have orthostatic hypotension, which manifests itself as higher blood pressure when sitting than when lying
down
184
Hypoglycemia with sulfonylurea:
a. As a rule, it requires hospitalization.
b. The most dangerous are preparations with a short-term but intense effect
c. They are common in kidney failure
d. In case of diarrhea or vomiting or fasting, sulfonylureas should not be
taken for fear of hypoglycemia
A,C,D
185
What is the definition of chronic kidney disease?
a. Glomerular filtration rate < 60 mL/min OR signs of renal impairment present
for at least 3 months
a. Glomerular filtration rate < 60 mL/min OR signs of renal impairment present
for at least 3 months
186
How many antihypertensive drugs are needed on average to control blood pressure at
a diabetic?
a. 1
b. 2
c. 3
c. 3
187
With idiopathic reactive hypoglycemia, we get:
a. Most often it appears on an empty stomach
b. It most often occurs 5 hours after a mixed meal
c. It is the result of functionally excessive secretion of insulin
d. It is mostly adrenergic stimulation after a meal
e. It is more common in obese people
f. It is more common in emotionally unstable women
f. It is more common in emotionally unstable women
188
To neuroglycopenic signs of hypoglycemia we don't add:
a. sweating
b. cramps
c. cognitive disorders
d. loss of consciousness
e. unusual behavior
a. sweating
189
The most common cause of hypoglycemia is:
a. alcoholism
b. insulinoma
c. exogenous hyperinsulinism
d. autoimmune event
e. advanced chronic renal failure
c. exogenous hyperinsulinism
190
What doesn't apply to alcohol hypoglycemia:
a. It is a common cause of hypoglycemia
b. It is the result of poor nutrition, alcohol and liver damage
c. Chronic liver damage is not a condition for alcoholic hypoglycemia
d. We treat her with glucagon. or concentrated glucose iv.
e. Severe hypoglycemia is not related to the amount of alcohol consumed
d. We treat her with glucagon. or concentrated glucose iv.
191
Hypoglycemia:
a. it is characterized by a diverse set of causes but a specific set of symptoms
b. it is mostly easily recognizable
c. it most often occurs in emotionally labile women
d. occurs in predominantly dry patients
e. is a characteristic symptom of many congenital metabolic disorders
e. is a characteristic symptom of many congenital metabolic disorders
192
Acute gastroenterocolitis increases the likelihood of:
a. hyperglycemia
b. hypoglycemia
b. hypoglycemia
193
Which of the following doesn't belong to the adrenergic symptoms of hypoglycemia?
a. Tachycardia
b. Confusion
c. Sweating
d. Pallor
e. Paresthesias around the mouth
f.Epileptiform convulsions
g. Trembling
b. Confusion
e. Paresthesias around the mouth
f.Epileptiform convulsions
194
The patient underwent a fasting test due to spontaneous hypoglycemia, which was interrupted
after 18 hours due to hypoglycemia with a blood glucose concentration of 2.4 mmol/l. At the same
time, a decreased concentration of C-peptide, an increased concentration of insulin, and no
sulfonylurea metabolites were detected in the urine. Most likely to go?
a. prediabetes
b. application of exogenous insulin
c. late postprandial hypoglycemia
d. incorrect dose of sulfonylureas
e. insulinoma
b. application of exogenous insulin
195
Circle the correct statements.
a.The difference between hypoglycemic coma and diabetic ketoacidosis (DKA) is that
hypoglycemic coma has an abrupt onset, while DKA has a slower onset..
b. In hypoglycemic coma and DKA, the heart action is tachycardic.
c. Kussmaul respiration is present in hypoglycemic coma and DKA.
A and B
196
Alcoholic hypoglycemia:
a. the degree of hypoglycemia is proportional to the amount of alcohol consumed
b. hypoglycemia often occurs only when the signs of intoxication subside
c. chronic liver failure is a condition for alcoholic hypoglycemia
d. we must objectively rule out hypoglycemia in every drunk person with
impaired consciousness
e. hypoglycemia is treated with glucose and glucagon
B and D
197
Hypoglycemia causes are not:
a. Acute liver failure
b. Acute renal failure
c. Acute myocardial infarction
d. Panhypopituitarism
e. Alcohol
c. Acute myocardial infarction
198
In type 1 diabetes, the serum concentration is increased
a. triglycerides
b. chylomicrons
c. HDL
d. LDL
a. triglycerides
b. chylomicrons
d. LDL
199
Which of the listed oral antidiabetics belong to insulin secretagogues?
a. metformin
b. SGLT-2 inhibitors
c. sulfonylureas
d. meglitinides (glinides)
e. DPP-4 inhibitors
f. acarbose
c. sulfonylureas
d. meglitinides (glinides)
200
STH inhibits the action of insulin on cells and increases insulin resistance
a. True
b. It's not true
a. True
