Diabetes

Question 1

What are the types of diabetes insipidus?

Answer 1

Central

Peripheral resistance to ADH

Question 2

Which type of diabetes is more concordant in monozygotic twins?

Answer 2

Type II

• Due to similar environment

Question 3

What is LADA?

Answer 3

Latent autoimmune diabetes of adults

Question 4

What are some non-lifestyle causes of T2DM?

Answer 4

Haemachromatosis

Cushing disease

Steroid use

Acromegaly

PCOS

Pregnancy

Drugs

• Anti-retrovirals, beta-blockers, thiazides

Question 5

What is hypermolar hyperglycaemic state? What does it cause?

Answer 5

Complication of T2DM with hyperglycaemia

• Osmostic diuresis > dehydration
• Lens swelling

Question 6

What are some presenting symptoms of diabetes?

Answer 6

Polyuria

Polydipsia

Blurred vision

Lethargy

Unexplained weight gain or loss

Symptoms of complications

DKA/HHS

Question 7

What are the cut offs for fasting glucose and glucose tolerance test for diagnosis?

Answer 7

Fasting >7.1

GT >11.1

Question 8

How many positive tests are required for the diagnosis of diabetes?

Answer 8

1 if symptomatic

2 if non-symptomatic

Question 9

What is the eGFR cutoff for metformin?

Answer 9

<35

Question 10

What is a severe side effect of metformin?

Answer 10

Lactic acidosis

Question 11

What dose of metformin are used?

Answer 11

500-1000mg BD

Question 12

What are the two signs of carpal tunnel?

Answer 12

Tinel’s - tapping

Phalen’s - reverse pray

Question 13

What is a postural drop defined as?

Answer 13

> 20/10

Question 14

What are the non-proliferative eye change found on fundoscopy?

Answer 14

Cotton wool spots

Microaneurysms

Microhaemorrhages

Question 15

What are the proliferative changes found on fundoscopy?

Answer 15

Neovascularisation

Vitreous haemorrhage

Fibrovascular proliferation

Question 16

What is the name of neovascularisation in the iris?

Answer 16

Rubeosis iridis

Question 17

What are the Argyll-Robinson pupils? Where do you see it?

Answer 17

Pupils that constrict when accommodating but not in response to light

DM

Syphilus

Question 18

What type of murmur might an AMI cause?

Answer 18

Regurgitation secondary to akinesis or ruptured papillary muscle

Question 19

How long does lantus work for? When does it peak?

Answer 19

16-24 hours

It doesn’t have one

Question 20

What are some smoking cessation drugs?

Answer 20

Varenicline (aka Champix)

Buproprion

Question 21

What are the DPP4 inhibitors?

Answer 21

Gliptins

Question 22

What is a GLP-1 analogue?

Answer 22

Exenatide

Question 23

What is the name of a alpha-glucosidase inhibitor?

Answer 23

Acarbose

Question 24

How do SGLT2 inhibitors work?

Answer 24

Inhibitor glucose absorption

Question 25

What is gliclazide?

Answer 25

A sulphonylurea

Question 26

What is the maximum dose of metformin?

Answer 26

1g BD

Question 27

What is an appropriate starting dose of lantus?

Answer 27

12U

Question 28

What is an appropriate starting insulin regimen in a T2DM?

Answer 28

Bed time lantus (glargine)

Question 29

What are some quick acting insulins?

Answer 29

Aspart (novorapid)

Lipro (Humalog)

Question 30

What are the two long acting insulins?

Answer 30

Determir (levermir)

Glargine (lantus)

Question 31

What are the diagnostic criteria for DKA?

Answer 31

pH <7.3

HCO3 <18

Hyperglycaemia

Question 32

What are the DDx for a high anion gap?

Answer 32

Aspirin

Renal failure

Ethanol

Acids - Ketoacids

• Lactic acid