Diabetes Quiz Flashcards
Mary is a 49 year old patient with a 35 year history of type 1 diabetes. She was also recently diagnosed with hypothyroidism; other than this she has no other medical conditions. What would her goal A1C be?
A. ≤7%
B. ≤6.5%
C. ≤6.0%
D. ≤7.5%
A.
If a 10 year old child with diabetes were to lose consciousness as a result of hypoglycemia, which of the following treatments could be used? Choose the best answer.
A. 250ml of apple juice
B. glucagon 3mg nasal spray
C. 4 Dex4 tablets
D. All of the options provided are correct
B.
Daniel (38yo) has a new diagnosis of type 2 Diabetes and is looking for a medication which will help lower his A1C the most as his primary preference. Aside from diabetes, he is otherwise healthy. Which of the following medications would he want to avoid as it has the least amount of efficacy on lowering A1C?
A. acarbose
B. glyburide
C. pioglitazone
D. dulaglutide
E. repaglinide
A.
David (70yo) has a 25 year history of T2DM. Additionally, he has hypertension, high cholesterol, CKD (eGFR 39), and he has had a previous stroke.
He is currently managed on metformin and gliclazide for his diabetes, and his A1C is 7.2.
What would you recommend for David?
A. nothing
B. add liraglutide
C. add empagliflozin
D. add pioglitazone
E. add sitagliptin
C.
Which of the following medications has been shown to have beneficial effects on the kidneys in someone with renal impairment?
A. acarbose
B. glyburide
C. dapagliflozin
D. gliclazide
E. metformin
C.
Which of the following medications is most associated with the occurrence of genital mycotic infections?
A. acarbose
B. dapagliflozin
C. exenatide
D. liraglutide
E. rosiglitazone
B.
Which of the following medications should not be used in conjunction with insulin due to increased risk of edema?
A. glyburide
B. pioglitazone
C. exenatide
D. dapagliflozin
E. repaglinide
B.
Which of the following insulin products most closely resembles the following pharmacokinetic properties:
Onset of action: 10 - 15 minutes
Peak: 1 hour
Duration of action: 4 hours
A. insulin regular (Humulin R)
B. Insulin glulisine (Apidra)
C. insulin neutral protamine hagedorn (Humulin N)
D. insulin glargine (Basaglar)
B.
Which of the following is/are an advantage of a long acting insulin analogue (LAIA) over an intermediate acting insulin?
A. greater efficacy
B. less nocturnal hypoglycemia
C. greater postprandial glucose control
D. all of the above
B.
Jane is 52 years old, 5 foot 4, and weighs 70kg. She has type 2 diabetes for which she is on 3 oral diabetes medications and her A1C is 8%. She is about to start insulin glargine. What dose of insulin should Jane be initiated on?
A. 4U
B. 10U
C. 15U
D. 2U
E. all of the options provided are reasonable
B.
George currently manages his blood sugar with metformin alone, and his A1C has been 6.7% for the past year. He has a capillary blood glucose monitor at home to check his blood sugar. Approximately how often should he be checking his blood sugar at home?
A. once a day
B. every two days
C. paired testing, 2-3 times a week
D. every 1 to 2 weeks
D.
When glucose is converted to glycogen and stored in the muscle, what is this process known as?
A. gluconeogenesis
B. glycogenesis
C. glycogenolysis
D. glucogenesis
B.
Which of the following is an example of a ketone body that is produced by the liver from fatty acids in periods of fasting?
A. aceto-butyrate
B. beta-hydroxybutyrate
C. alpha-carboxylic acid
D. keto-cylic acid
E. all of the options provided are ketones
B.
In which of the following types of diabetes is the genetic link the highest?
A. type 1
B. type 2
C. maturity onset diabetes of the young
D. gestational diabetes
B.
How is pre-diabetes defined based on HbA1C levels?
A. A1C 6.0-6.4%
B. A1C 5.5 - 5.9%
C. A1C 6.5 - 6.9%
D. A1C 7.0 - 7.4%
A.
Which of the following defects occurs in type 2 diabetes?
A. Decreased incretin effect
B. Increased glucose reabsorption in the kidney
C. Increased hepatic glucose production
D. Increased lipolysis
E. All of the options provided occur in T2DM
E.
Which of the following is NOT a risk factor for the development of hyperglycemia?
A. Corticosteroid use
B. Bipolar disorder
C. Smoking
D. Orlistat use
D.
Which of the following statements regarding type 2 diabetes in children is TRUE?
A. Although incidence rates rose the past decade, they are now levelling off
B. A high socio-economic status is a risk factor
C. Treatment options consist of metformin, insulin, and liraglutide in those >10 years old
D. gestational diabetes in the mother is protective against T2DM in children
C.
Which of the following is TRUE with respect to gestational diabetes (GDM)?
A. The drug of choice for treatment is insulin
B. The drug of choice for treatment is metformin
C. The drug of choice for treatment is gliclazide
D. Medications are not indicated for use and treatment should be solely approached with diet and exercise
A.
Which of the following can be used as a screening test for T2DM in a child? Choose the best answer.
A. FPG
B. 2hr 75g OGTT
C. A1C
D. A and B
E. A, B, and C
D.
Which of the following may occur with long term use of metformin therapy?
A. B3 deficiency
B. B6 deficiency
C. B12 deficiency
D. iron deficiency
C.
What is the reasoning for an A1C target of <7% for most people with diabetes?
A. in clinical trials, this resulted in fewer microvascular complications
B. in clinical trials, this resulted in fewer macrovascular complications
C. this is the amount that provides the best balance between glycemic control and hypoglycemia
D. going below this value provides no additional benefits
A.
Which of the following measures glucose levels in the interstitial fluid?
A. A FreeStyle Libre CGM
B. A Dexcom G7 CGM
C. A Contour Next CBG meter
D. A and B
E. A, B, and C
D.
Which of the following would not be considered a low glycemic index food?
A. whole grain bread
B. apple
C. sweet potato
D. orange juice
D.
Someone is counting carbs, and this is what they have in their labels
Food X: CHO: 16g, Fibre 1g, Sugar 0g
Food Y: CHO: 29g, Fibre 0g, sugar, 2g
Food X: CHO: 43g, Fibre 5g, sugar 6g
How much CHO would they need to take into account when determining how much insulin they need?
A. 88g
B. 96g
C. 82g
D. 102g
C.
Which of the following is TRUE regarding exercise in diabetes?
A. carb loading is necessary prior to all forms of exercise to prevent hypoglycemia
B. it is important to monitor glucose levels in someone who is exercising if they have type 1 diabetes, but not type 2 diabetes
C. very intense exercise decreases blood sugar levels to a greater extent than low intensity exercise
D. low intensity exercise can improve insulin sensitivity for the next 48 hours
D.
Ideally, when should insulin lispro be administered?
A. 30 minutes before a meal
B. 15 minutes before a meal
C. 45 minutes before a meal
D. 10 minutes after a meal
B.
Which of the following insulins are cloudy in appearance?
A. Hypurin R (regular pork insulin)
B. Humulin R (regular insulin)
C. Basaglar (insulin glargine)
D. Novolin ge NPH
E. Entuzity (regular insulin U500)
D.
Which drug has a contraindication for use in someone with a history of medullary thyroid cancer?
A. metformin
B. glyburide
C. semaglutide
D. dapagliflozin
E. linagliptin
C.
Max has T2DM for 3 years and his A1C is 7.8%. He is currently on metformin. He has no other medical conditions besides hypertension. He has been told he needs another agent for his blood sugar. He says he wants something that is taken orally, and he would prefer something that will not cause any weight gain or hypoglycemia. What would you recommend for Max?
A. Add sitaglitpin
B. Add dulaglutide
C. Add gliclazide
D. Add repaglinide
E. Add tirzepatide
A.
Peter has T2DM for 13 years and his A1C is 8%. He is currently on metformin. He has no other medical conditions besides hypertension. What should Max’s target blood pressure be?
A. <140/90
B. <135/85
C. <130/80
D. <125/75
C.
Sasha is on metformin, sitagliptin as well as an SGLT2i and basal insulin. Her A1C is still elevated (A1C 7.3%). She wants to add something to help bring her glucose down below 7%. Her preference is to avoid hypoglycemia and weight gain. What would you suggest?
A. Add a GLP1RA
B. Lower the dose of the basal insulin and add a suppertime insulin
C. Remove sitagliptin and add semaglutide
D. Remove the SGLT2 inhibitor and the basal insulin, and add dulaglutide
C.
Which of the following is an example of a neuroglycopenic symptom seen with hypoglycemia?
A. hunger
B. difficulty speaking
C. palpitations
D. sweating
E. all of the options provided
B.
What is TRUE about diabetic ketoacidosis?
A. it most commonly occurs in longstanding type 2 diabetes
B. it is characterized by high BG, low pH, and ketones
C. it is characterized by high BG, normal ketones, and a large anion gap
D. it is characterized by high BG, high ketones, and an elevated pH
B.
Which medication does not need to be withheld in a diabetes patient who is acutely ill with influenza?
A. metformin
B. gliclazide
C. canagliflozin
D. liraglutide
D.
TRUE or FALSE? Everyone with diabetes >55 years old should be on an ACE inihibitor?
A. true
B. false
B.
A diabetes patient with nephropathy would benefit from which of the following? Choose the best answer.
A. optimal BP control
B. use of ramipril
C. use of canagliflozin
D. B and C
E. A, B, and C
E.
Which of the following would be the most appropriate recommendation for someone with an ASA allergy newly diagnosed with painful diabetic peripheral neuropathy?
A. max dose acetaminophen
B. max dose naproxen
C. acetaminophen and codeine
D. cannabis
E. gabapentin
E.
Which of the following medications will not typically cause hypoglycemia on their own?
A. liraglutide
B. sitagliptin
C. gliclazide
D. A and B
E. A, B, and C
D.
Which of the following statements is TRUE with respect to differences between continuous glucose monitoring (CGM) and capillary blood glucose (CBG) monitoring?
A. CGM is better for someone with T1DM but not T2DM
B. If CGM and CBG were to be checked at the exact same time, CBG is more accurate
C. CGM can tell you the time a person with diabetes spends in the desired glucose range
D. CGM can tell you if you are burning ketones as well, whereas CBG can not
C.
Gromwell is a 50 year old male with a new diagnosis of type 2 diabetes. He was been told that he needs to eat better and exercise. Which of the following recommendations is most true for Gromwell?
A. You should engage in resistance training at least 4 times per week
B. You should increase your exercise incrementally each day, so that by the end of this week you are getting at least 150 minutes of exercise per week
C.Your ultimate goal should be 30 minutes of aerobic exercise 3 to 4 days per week
D. Any bit of exercise is better than none, aim for aerobic exercise at least 10 minutes in duration and incorporate some resistance training at least twice a week
D.
Which of the following medical conditions is/are someone with type 1 diabetes at an increased risk of developing some point in time? Choose the best answer.
A. thyroid disease and gastroparesis
B. obstructive sleep apnea and thyroid disease
C. depression and erectile dysfunction
D. depression and obstructive sleep apnea
E. all of the above
E.
Samantha is 47 years old with type 2 diabetes. and she is currently only being managed with diet and exercise. She does not take any prescription medications and has no other chronic medical conditions. She just went for bloodwork and her A1C was 6.6%, LDL was 1.8 mmol/L, and her most recent blood pressure reading at her doctor’s office was 127/78. What medications, if any, would you recommend for Samantha?
A. None - carry on as is
B. Add a statin
C. Add metformin and a statin
D. Add metformin and a statin and an ACEi
E. Add a statin and an ACEi
B.
Which of the following is important to tell someone living with diabetes with respect to their foot care?
A. Inspect your feet weekly and wear properly fitted shoes
B. Only purchase the lowest strength salicylic acid product if treating a corn on bottom of foot
C. Apply lotion to soles, heels, and between the toes to help prevent cracking
D. trim the toenails straight across and file any sharp edges
D.
Which of the following medications has the rare adverse effect of lactic acidosis?
A. dapagliflozin
B. liraglutide
C. rosiglitazone
D. metfornin
D.
Which of the following medications has been shown to decrease hospitalization for heart failure in diabetes patients with either preserved or reduced ejection fraction?
A. semaglutide SQ
B. semaglutide oral
C. empagliflozin
D. metformin
C.
Which of the following medications has the best evidence for decreasing major adverse cardiac events as well as decreasing blood sugar levels?
A. dapagliflozin
B. sitagliptin
C. pioglitazone
D. liraglutide
D.
Which of the following has been shown to be able to induce remission (to normal glucose levels without the use of antihyperglycemic medications) of type 2 diabetes?
A. bariatric surgery
B. low calorie diets
C. exercise training with a calorie-restricted diet
D. all of the above
E. none of the above
D.
Tirzepatide (Mounjaro) was recently approved by Health Canada for the treatment of T2DM. What is the mechanism of action of this drug?
A. It is a GLP1RA combined with a long acting basal insulin
B. It is a glucagon-like peptide-1 and glucose-dependent insulinotropic peptide receptor agonist
C. it is a GLP1RA combined with ghrelin receptor inhibitor
D. It is a GIP agonist
B.
