chronic disease

Question 1

lipid monitoring can start when?

Answer 1

age 40

Question 2

what A1c level is targeted for diabetic children and adolescents?

Answer 2

7.5 and under

Question 3

criteria for diagnosis of diabetes

Answer 3

A1C>6.5 or
fasting glucose >126
or 2 hr glucose after OGTT >200

or in a pt w/ symptoms of hyperglycemia, a random glucose of >200

Question 4

when should you test for diabetes in asymptomatic ppl?

Answer 4

adults of any age that are overweight or obese and who have 1 or more risk factors for diabetes

in those w/o these risk factors, begin testing at 45

if tests are normal, repeat tests every 3 yrs

Question 5

when to screen pregnant for diabetes?

Answer 5

at first visit if risk factors for undiagnosed type 2 DM

at 24-28 wks if no risk factors for GDM

Question 6

what level A1c prevents microvascular dis?

Question 7

normal hemoglobin a1c for non diabetic

Answer 7

4-5.6

Question 8

tx of type 1 diabetes

Answer 8

multiple daily injections (basal and bolus) or continuous subcu insulin infusion

Question 9

in type 2 diabetes, if noninsulin monotherapy doesn’t help reach a1c goal in 3 months, what should you do?

Answer 9

add second oral agent or insulin

Question 10

alcohol risk in diabetics

Answer 10

if consume much, can place pt at risk for delayed hypoglycemia

Question 11

when is bariatric surgery recommended for type 2 diabetics?

Answer 11

BMI>35

Question 12

BP goal for those with diabetes and HTN

Question 13

what to do for pts w BP >120/80

Answer 13

advise lifestyle changes (weight loss, diet, decrease alcohol intake, exercise)

Question 14

tx for those with diabetes and HTN should include

Answer 14

ACE inhibitor or ARB (level C evidence)

Question 15

statins should be added to regimen for diabetics in what situations?

Answer 15

regardless of baseline lipid levels, if:

• overt CVD
• over 40 and have one or more risk factors for CVD

Question 16

diabetic pts with CVD should get what tx

Answer 16

aspirin and statin

consider ACE inhibitor

Question 17

for diabetics w/ elevated albumin secretion, what tx?

Answer 17

ACE or ARB

Question 18

BP goal for over 60 yo

Question 19

BP goal for under 60

Question 20

in general nonblack population, initial anti-HTN tx, including for those with diabetes, should be

Answer 20

thiazide
Ca ch blocker
ACE
or ARB

Question 21

in general black population, including those with diabetes, anti-HTN tx should include

Answer 21

thiazide

or Ca ch blocker

Question 22

in 18 yo or older w HTN and CKD, initial therapy should include

Answer 22

ACE inhib or ARB to improve kidney outcomes

Question 23

statin therapy is recommended in which groups

Answer 23

clinical atherosclerotic CVD
LDL>190
40-75 yo w/ diabetes and LDL 70-189
40-75 yo w/o diabetes but 10 yr clinical atheroscler CVD risk of >7.5%