Type 2 diabetes Flashcards
(36 cards)
A patient with uncomplicated type 2 diabetes attends for review. His Blood pressure is 170/90mmHg?
140/80
A patient with previously uncomplicated T2DM attends for review 12 months later. He has had a Acute MI and angioplasty since his last attendance. What is an appropriate BP target?
130/80
What is the first line antihypertensive of choice?
ACE inhibitor
What is the target LDL Cholesterol for all patients with Type 2 diabetes?
2.0 mmol/l
What proportion of patients with type 2 diabetes will succumb to cardiovascular complications?
75%
Which of the following risk factors is most important in terms of reducing cardiovascular risk in a patient with Type 2 diabetes?
Cholesterol
A 65 year old male attend diabetes clinic. He reports pain in the lower limbs. The pain specifically occurs in the calf after walking approximately 50 yards and is relieved by rest. His co-morbidity includes Hypertension and dyslipidaemia, he smokes 10 cigarettes per day.
What is the likely diagnosis?
Intermittent claudication
Which study showed long term benefit of reduced ischaemic heart disease from early intensive glycaemic control in patients with type 2 Diabetes?
UKPDS - UK prospective diabetes study
In a patient newly diagnosed with type 2 Diabetes, following lifestyle intervention what is the first line anti-diabetic treatment?
Metformin
Which of these treatments is associated with hypoglycaemia as a potential side effect? A.Gliclazide B.Pioglitazone C.Metformin D.Sitagliptin E.GLP-1 receptor agonist
Gliclazide
A 21 year old with Type 2 diabetes attend clinic. She has a BMI of 36 and you note hyperpigmentation of the skin in the axilla bilaterally. What is the likely diagnosis? A.Acanthosis Nigricans B.Malignant melanoma C.Necrobiosis Lipoidica diabeticatorum D.Granuloma annulare E.Linea nigra
Acanthosis Nigricans
Which agent is associated with potential weight gain as an adverse effect? A.Liraglutide B.Pioglitazone C.Metformin D.Sitagliptin E.Exenatide
Pioglitazone
What causes weight gain in pioglitazone?
Salt and water production
Which agent is theoretically associated with a risk of lactic acidosis?
Metformin
At what level of eGFR should one stop
Metformin?
30ml/min/1.73m2
Which of the following studies suggested an adverse outcome from intensive glucose lowering in patients with longstanding type 2 Diabetes? A. ACCORD B. ADVANCE C. Veteran’s study D. Steno 2 E. HOPE
ACCORD
Which of the following findings would cause you to discontinue ACE inhibitor treatment? A.Albumin:creatinine ratio 30mg/mmol B.Serum creatinine 215 μmol/l C.Serum potassium 5.5mmol/l D.Serum sodium 132mmol/l E.HbA1c 9.0%
Serum creatinine 215 μmol/l
Which of the following findings is suggestive of cardiac autonomic neuropathy?
A. Absent beat to beat variation in pulse rate with deep respiration
B. A QT interval of 390 milliseconds (0.39 seconds)
C. Tachycardia during Valsalva manouver
D. Increase in systolic BP of 10mmHg on standing
E. Resting pulse rate of 60
Absent beat to beat variation in pulse rate with deep respiration
A patient is complaining of erectile dysfunction. Investigations show normal gonadotrophin levels and normal testosterone levels. You are considering treatment with a PD 5 inhibitor (Viagra). He has a history of ischaemic heart disease. Which of his regular medications is a contraindication to PD 5 inhibitor treatment? A. Aspirin B. Beta blockers C. ACE inhibitor D. Statin E. Isosorbide mononitrate
Isosorbide mononitrate - angina meds
Which electrolyte disturbance is a potential concern when dosing ACE inhibitors? A.Hyperkalaemia B.Hypernatraemia C.Hypokalaemia D.Hypomagnaesaemia E.Hypercalcaemia
Hyperkalaemia
What level of HbA1c do we aim to achieve to reduce the microvascular complications of diabetes? A.10mol/mmol (1.0%) B.48mol/mmol (6.5%) C.53mol/mmol (7.0%) D.64mol/mmol (8.0%) E.70mol/mmol (8.5%)
53mol/mmol (7.0%)
At what time of day are basal levels of insulin at their highest? A.Midnight to 4am B.4am to 10am C.Midday to 4pm D.4pm to 8pm E.8pm to midnight
4am until 10am
Which gut peptides are associated with the incretin effect A.Gastrin B.Glucagon Like Polypeptide 1 C.Somatostatin D.Glucagon E.Polypeptide P
GLP 1
what levels of the following would you need to diagnose T2DM? random plasma glucose fasting plasma glucose oral glucose tot. test HbA1C
random plasma glucose >11.1 with symptoms
fasting plasma glucose >7
oral glucose tot. test 75gm after 10hr fast
HbA1C >6.5
