Diabetes

Question 1

In a patient with suspected T1DM what 3 things should we ask about in a child?

1 - dysuria, thirst and weight gain
2 - dysuria, thirst and weight loss
3 - polyuria, thirst and weight loss
4 - polyuria, thirst and weight gain

Answer 1

3 - polyuria, thirst and weight loss

Question 2

In an adult with suspected T2DM, what 3 things should we ask about?

1 - dysuria, thirst and vision changes/blurry
2 - polyuria, thirst and vision changes/blurry
3 - polyuria, thirst and weight loss
4 - polyuria, thirst and nausea

Answer 2

2 - polyuria, thirst and vision changes/blurry

Question 3

What 2 tests can be performed quickly to diagnose a patient with T2DM?

1 - fasting blood glucose and random glucose test
2 - fasting blood glucose and OGTT
3 - HbA1c and fasting blood glucose
4 - HbA1c and OGTT

Answer 3

3 - HbA1c and fasting blood glucose

Question 4

If a patient has symptoms such as tiredness, fungal infections, vision changes and/or thirst what are the cut offs for HbA1c and fasting plasma glucose (FPG)?

1 - HbA1c >48mmol/mol and FPG >7mmol/L
2 - HbA1c <48mmol/mol and FPG >7mmol/L
3 - HbA1c >48mmol/mol and FPG >4mmol/L
4 - HbA1c >48mmol/mol and 2 separate >10mmol/L

Answer 4

1 - HbA1c >48mmol/mol and FPG >7mmol/L

- a random blood glucose would be >11mmol/L

Question 5

If a patient has NO symptoms such as tiredness, fungal infections, vision changes and/or thirst what are the cut offs for HbA1c and fasting plasma glucose (FPG)?

1 - HbA1c >48mmol/mol and FPG >7mmol/L
2 - 2 separate FPG >7mmol/L
3 - 2 HbA1c >48mmol/mol
4 - HbA1c <48mmol/mol and FPG >7mmol/L

Answer 5

2 - 2 separate FPG >7mmol/L

Question 6

What are the 3 main pathological causes of T2DM?

1 - beta cell apoptosis, insulin resistance, elevated blood glucose
2 - beta cell hypertrophy, insulin resistance, elevated blood glucose
3 - reduced insulin production, increased insulin sensitivity, increased hepatic gluconeogenesis
4 - reduced insulin production, insulin resistance, elevated blood glucose

Answer 6

4 - reduced insulin production, insulin resistance, elevated blood glucose

Question 7

Which tissues/organs are at particular risk in diabetes?

1 - heart, eyes, kidneys
2 - eyes, kidneys, peripheral nerves
3 - eyes, kidneys, livers
4 - eyes, kidneys, bladder

Answer 7

2 - eyes, kidneys, peripheral nerves

Question 8

How often are patients with diabetes followed up by their GPs or diabetic nurses?

1 - weekly
2 - monthly
3 - yearly
4 - bi-annually

Answer 8

3 - yearly

Question 9

What is the first line treatment for T2DM when lifestyle change alone has failed?

Answer 9

• metformin

- can be started immediately if patient has symptoms and blood glucose is high

Question 10

When a patient is started on diabetes medication, initially how often should their HbA1c be checked?

1 - weekly
2 - every 3 weeks
3 - monthly
4 - every 3 months

Answer 10

2 - every 3 weeks

Question 11

When a patient is taking diabetes medication, what is the target range for HbA1c?

1 - 48-70mmol/mol
2 - 44-58mmol/mol
3 - 50-70mmol/mol
4 - 48-58mmol/mol

Answer 11

4 - 48-58mmol/mol

Question 12

A patient, regardless of if they have diabetes or not should be prescribed a angiotensin converting enzyme (ACE) inhibitor if they are at what % risk of a cardiovascular event in the next 10 years?

1 - >10%
2 - >20%
3 - >30%
4 - >40%

Answer 12

1 - >10%

- based on the Framlington studies