DISORDERS OF GLUC METABOLISM

Question 1

Post-absorptive/Fasting hypoglycemia occurs after

Answer 1

10 hours without food; secondary to hyperinsulinism, hormonal deficiencies, genetic disorders, autoimmunity, or drug-induced

Question 2

Post-prandial/Alimentary/Reactive hypoglycemia occurs

Answer 2

Usually within 4 hours after eating a meal

Question 3

Symptoms of hypoglycemia appear after

Answer 3

10 hours post-prandial at 50-55 mg/dL

Question 4

Neurogenic symptoms of hypoglycemia include

Answer 4

Tremulousness, palpitations, anxiety, diaphoresis, hunger, paresthesias

Question 5

Neuroglycopenic symptoms of hypoglycemia include

Answer 5

Dizziness, tingling, blurred vision, behavioral changes, seizure, and coma

Question 6

Whipple’s triad of hypoglycemia includes

Answer 6

Symptoms of hypoglycemia, low plasma glucose level, relief of symptoms with correction of hypoglycemia

Question 7

Diagnostic criteria for insulinoma include a change in glucose level

Answer 7

≥25 mg/dL under controlled fasting conditions

Question 8

Diagnostic criteria for insulinoma: Increased insulin levels

Answer 8

≥41.7 pmol/L

Question 9

Diagnostic criteria for insulinoma: Increased proinsulin levels

Answer 9

≥5 pmol/L

Question 10

Diagnostic criteria for insulinoma: Increased C-peptide levels

Answer 10

≥0.2 nmol/L

Question 11

Diagnostic criteria for insulinoma: Decreased B-hydroxybutyrate

Answer 11

≤2.7 mmol/L

Question 12

Insulin-to-C-peptide ratio in insulinoma

Answer 12

5:1 to 15:1

Question 13

Type 1 diabetes is characterized by

Answer 13

β cell destruction leading to absolute insulin deficiency

Question 14

Type 1 diabetes can be

Answer 14

Immune-mediated (autoimmune type I, juvenile) or idiopathic

Question 15

Type 2 diabetes is characterized by

Answer 15

Insulin resistance with progressive insulin deficiency

Question 16

Type 2 diabetes is more common in

Answer 16

Adults

Question 17

Other types of diabetes include

Answer 17

Genetic defects of β cell function, genetic defects in insulin action, diseases of the exocrine pancreas, endocrinopathies, drug- or chemical-induced, infections, uncommon forms of immune-mediated diabetes, other genetic syndromes

Question 18

Gestational diabetes is

Answer 18

Glucose intolerance during pregnancy that disappears post-partum but may convert to type 2 DM in 30-40% of cases within 10 years

Question 19

Type 1 diabetes accounts for

Answer 19

<10% of diabetes cases

Question 20

Type 1 diabetes usually has an onset in

Answer 20

Childhood (juvenile)

Question 21

Risk factors for Type 1 diabetes include

Answer 21

Autoimmunity (+ auto-abs), Genetic predisposition (HLA DR3 and DR4)

Question 22

Therapy for Type 1 diabetes involves

Answer 22

Insulin injection

Question 23

Ketones in Type 1 diabetes are a product of

Answer 23

Lipolysis

Question 24

Acute complication of Type 1 diabetes is

Answer 24

Diabetic ketoacidosis (Increased BHA)

Question 25

Type 2 diabetes accounts for

Answer 25

>90% of diabetes cases

Question 26

Risk factors for Type 2 diabetes include

Answer 26

Family history of DM, high-risk minority population, PCOS, GDM, overweight tendencies, hypertension, dyslipidemia, history of CVD

Question 27

Therapy for Type 2 diabetes involves

Answer 27

Lifestyle changes, oral hypoglycemic agents, may require insulin

Question 28

Acute complication of Type 2 diabetes is

Answer 28

Hyperglycemic hyperosmolar non-ketotic coma

Question 29

Type 2 diabetes panic value is

Answer 29

≥500 mg/dL

Question 30

Lab findings in Type 2 diabetes include

Answer 30

Increased PG, serum osmolarity, urine glucose, urine specific gravity, decreased pH, sodium

Question 31

Common symptoms of Type 2 diabetes include

Answer 31

Polyuria, Polydipsia, Polyphagia (3Ps), pruritus, poor wound healing

Question 32

Long-term complications of Type 2 diabetes include

Answer 32

Microvascular complications (nephropathy, retinopathy, neuropathy), Macrovascular complications (CAD, CVA)

Question 33

Nephropathy in Type 2 diabetes is characterized by

Answer 33

The earliest indicator of microalbuminuria

Question 34

Retinopathy in Type 2 diabetes can lead to

Answer 34

Blindness

Question 35

Neuropathy in Type 2 diabetes can lead to

Answer 35

Numbness, pain, and loss of sensation

Question 36

Macrovascular complications of Type 2 diabetes include

Answer 36

CAD (Myocardial infarction), CVA (stroke)

Question 37

Type 1 diabetes is typically diagnosed based on

Answer 37

Presence of auto-antibodies and increased C-peptide levels

Question 38

Risk factors for gestational diabetes include

Answer 38

Obesity, age >25, family history, high-risk ethnicity (African American, Latino, Native American, etc.)

Question 39

Gestational diabetes may convert to type 2 diabetes within

Answer 39

10 years in 30-40% of cases