DIABETES Flashcards by Christian Linatoc

Which of the following requires insulin for survival?

A. Type 1 DM
B. Type 2 DM
C. Type 3 DM
D. Type 4 DM
E. Two of the options
F. All of the options

A. Type 1 DM

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All of the following are TRUE about gestational DM EXCEPT:

A. Glucose intolerance develop during 2nd or 3rd trimester of pregnancy
B. Diabetes is reversible
C. Women with GDM undergo lifelong screening for development of diabetes at least 3 years
D. Children born to a mother with DM has a risk of developing in the next 10-20 years
E. None of the options

E. None of the options

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All of the following are criteria for the diagnosis of DM EXCEPT:

A. Symptoms of diabetes + RBG concentration of 200 mg/dL
B. FPG greater than or equal to 126 mg/dL (no caloric intake for at least 6 hours)
C. HbA1C >6.5%
D. 2-h PG of 200 mg/dL during an OGTT (75 g anhydrous glucose)
E. None of the options

B. FPG greater than or equal to 126 mg/dL (no caloric intake for at least 6 hours)

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Which of the following is/are the most reliable and convenient test/s for identifying DM in asymptomatic individuals?

A. HbA1C
B. FPG
C. 2-h PG
D. OGTT
E. Two of the options
F. All of the options

E. Two of the options

HbA1C or FPG

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All of the following are TRUE about ADA recommendation on type 2 diabetes screening EXCEPT:

A. Children aged >10 years old
B. Adults aged >45 years old 
C. Overweight with risk factor
D. Two of the options
E. None of the options

E. None of the options

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All of the following are risk factors for type 2 DM EXCEPT:

A. Family history
B. Physical inactivity
C. Race
D. Prev. identified HbA1C of <5.6%
E. Hypertension (140/90 mm Hg)

D. Prev. identified HbA1C of <5.6%

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Which of the following is the most important regulator of metabolic equilibrium in glucose homeostasis?

A. Glucagon
B. Insulin
C. Somatostatin
D. Peptide YY
E. None of the options

B. Insulin

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This is a useful marker for insulin secretion and allows discrimination of endogenous and exogenous sources of insulin in the evaluation of hypoglycemia.

A. C-reactive protein
B. C-peptide 
C. Insulin
D. Glucagon
E. ESR

B. C-peptide

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This is a major component of amyloid fibrils found in the islets of patients with type 2 DM.

A. IAPP
B. Amylin
C. Incretin
D. GLP-1
E. Two of the options
F. All of the options

E. Two of the options

IAPP / Amylin

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Rate limiting step of glucose metabolism that controls glucose-regulated insulin secretion.

A. Phosphofructokinase
B. Glucokinase
C. Pyruvate kinase
D. Glucose phosphatase

B. Glucokinase

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Which of the following is characterized by the development of two or more ICAs but with normoglycemia?

A. Stage 1 type 1 DM
B. Stage 2 type 1 DM
C. Stage 3 type 1 DM
D. Stage 1 type 2 DM
E. Stage 2 type 2 DM

A. Stage 1 type 1 DM

Stage 1 = normoglycemia
Stage 2 = dysglycemia
Stage 3 = hyperglycemia

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All of the following are TRUE about genetic considerations of type 1 DM EXCEPT:

A. Concordance in identical twins ranges b/w 70 and 90%
B. The major susceptibility gene is located in HLA region on chromosome 5
C. HLA region encodes for MHC class II molecules which are involved in immune responses
D. Most individuals have HLA DR3 and/or DR4
E. Two of the options
F. None of the options

E. Two of the options

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Pancreatic islets have the modest infiltration of which of the following type of cells?

A. Neutrophils
B. RBCs
C. Lymphocytes
D. Leukocytes
E. Eosinophils

C. Lymphocytes

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Beta cells are toxic to all of the following cytokines EXCEPT:

A. TNF-a
B. Interferon-y
C. IL-1
D. IL-17

D. IL-17

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Which of the following is the biosynthetic enzymes for the neurotransmitter GABA?

A. GAD
B. IAA
C. ICA-512
D. ZnT-8

A. GAD

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Most of the autoantigens are not beta cell-specific, which raises the question of how the beta cells are selectively destroyed. Of these autoantigens, which is beta-cell specific?

A. GAD
B. IAA
C. ICA-512
D. ZnT-8
E. IA-2

D. ZnT-8

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Which of the following is the most prominent environmental trigger for type 1 DM?

A. Coxsackie virus
B. Rubella virus
C. Cytomegalovirus
D. Dengue virus

A. Coxsackie virus

All of the following are features that can be seen in patients with type 2 DM EXCEPT:

A. Acanthosis nigricans
B. Hirsutism
C. Acne
D. Oligomenorrhea in women
E. None of the options

E. None of the options

All of the following are characteristics of type 1 DM EXCEPT:

A. Onset prior to 30 years old
B. Lean body habitus
C. Requires insulin as initial therapy
D. Develop DKA and HHS
E. Increased risk of other autoimmune diseases

D. Develop DKA and HHS

All of the following are part of the guidelines for comprehensive medical care for patients with diabetes EXCEPT:

A. Individualized glycemic goal
B. HbA1c testing (2-4 times / year)
C. Nutrition therapy
D. Eye and foot exam
E. None of the options

E. None of the options

This refers to a well-developed service base and with health care funding systems

A. Recommended care
B. Limited care
C. Comprehensive care
D. Complete care
E. Advanced care

A. Recommended care

Urine ketone monitoring is most useful in assessing what type/s of DM?

A. Type 1
B. Type 2
C. Type 3
D. Type 4
E. Two of the options
F. Can be used in all types of DM

A. Type 1

What type of medical nutrition therapy is directed at preventing or delaying the onset of type 2 DM in high-risk individuals?

A. Primary
B. Secondary
C. Tertiary
D. Quaternary

A. Primary

Secondary = improving glycemic control
Tertiary = managing complications

All of the following are nutritional recommendations for adults with diabetes of prediabetes EXCEPT:

A. Low-fat dairy product intake
B. Mediterranean-style diet rich in monosaturated fatty acids
C. Minimal trans fat consumption
D. Sucrose preferred over fructose
E. Two of the options
F. None of the options

D. Sucrose preferred over fructose

Fructose preferred over sucrose

According to ADA recommendation, how long should a diabetic patient exercise? ``` A. 60 min/week B. 90 min/week C. 120 min/week D. 150 min/week E. 180 min/week ```

D. 150 min/week

Which of the following is the major site for metabolic fuel consumption in resting state? ``` A. Cardiac muscle B. Smooth muscle C. Skeletal muscle D. Brain tissues E. Liver tissues ```

C. Skeletal muscle

Which of the following is contraindication to vigorous exercise in patients with type 2 DM? ``` A. Neuropathy B. Nephropathy C. Retinopathy D. Cardiomyopathy E. Liver disease ```

C. Retinopathy

This is the standard care in diabetes management. A. Self-monitoring of blood glucose B. Managing of glycemic control C. Managing blood pressure < 140/90 mmHg D. Weight loss and physical activities

A. Self-monitoring of blood glucose Measurement of HbA1C = standard method for assessing long-term glycemic control

According to ADA recommendations, how frequent should HbA1c be measured in patients achieving their glycemic control? ``` A. At least once per year B. At least twice per year C. At least thrice per year D. At least four times per year E. >5 times per year ```

B. At least twice per year

Which of the following HbA1c target is applicable for the patients with impaired awareness of hypoglycemia? A. <6.0 or 6.5% B. <7.0% C. <7.5% or 8% D. >8.5%

C. <7.5% or 8% For all individuals = <7% Elderly with chronic illnesses = 8.0 or 8.5% NOT beneficial = <6%

Which of the following insulin preparations have the native insulin amino acid sequence? ``` A. Aspart B. Lispro C. NPH D. Glargine E. Degludec ```

C. NPH

Which of the following insulin preparations has the longest duration? A. Degludec B. Detemir C. Glargine D. NPH

A. Degludec

Metformin should not be used in patients with renal insufficiency of what GFR level? A. <30 ml/min B. <45 ml/min C. <60 ml/min D. <75 ml/min

B. <45 ml/min (moderate)

Which of the following drugs can cause urticaria? ``` A. Alogliptin B. Acarbose C. Metformin D. Mitiglinide E. Canagliflozin ```

A. Alogliptin = DPP IV Inhibitors "GLIPTIN"

Which of the following drugs is C/I in patients with CHF? ``` A. Biguanides B. TZD C. DPP IV inhibitors D. SGL2 inhibitors E. Two of the options F. None of the options ```

E. Two of the options

Which of the following is C/I in patients with IBD? ``` A. GLP-1 agonists B. DPP IV inhibitors C. a-glucosidase inhibitors D. biguanides E. Sulfonylureas ```

C. a-glucosidase inhibitors

All of the following can cause hypoglycemia EXCEPT: ``` A. Mitiglinide B. Glipizide C. Lispro D. Miglitol E. Detemir ```

D. Miglitol

Which of the following TZD drugs raises HDL and LDL but lowers TG? A. Troglitazone B. Rosiglitazone C. Pioglitazone D. None of the options

C. Pioglitazone

All of the following are combinations that are successful in type 2 DM EXCEPT: ``` A. Metformin + second oral agent B. Metformin + GLP-1 agonist C. Metformin + insulin D. Long actin insulin + GLP-1 agonist E. None of the options ```

E. None of the options

Which of the following surgical therapies is recommended for type 1 DM? A. Bariatric surgery B. Metabolic surgery C. Whole pancreas transplantation D. Pancreaticoduodenectomy

C. Whole pancreas transplantation Bariatric = type 2 DM