endocrine questions Flashcards
what is the diagnostic threshold for diabetes?
fasting blood glucose ≥ 126 mg/dl
Diabetes can be diagnosed as: 1) random plasma glucose level >11.1 mmol/L (200 mg/dl), or 2) fasting plasma glucose >7.0 mmol/L (126 mg/dl), or 3) 2-hour plasma glucose >11.1 mmol/L (200 mg/dl) after an OGTT, 4) glycated haemoglobin ( HbA1c) ≥ 6.5% (48 mmol/mol). In the absence of specific symptoms of the disease, each test must be confirmed on a subsequent occasion (with the same or a different test)
what is insulin deficiency associated with?
increased ketogenesis
Absolute insulin deficiency leads to an accelerated lipolysis in the adipose tissue with a consequent increased flux of free fatty acids to the liver. Normally, in the liver fatty acids undergo beta-oxidation to acetyl CoA, which is totally oxidised in the Krebs cycle. In an insulin-deficient state, the capacity of the liver to oxidise all acetyl CoA is exceeded and ketone bodies are formed.
The test for checking mean plasma glucose concentration over the previous 8-10 weeks is?
Hemoglobin A1c
Haemoglobin A1c expresses the amount of haemoglobin that is combined with glucose. The highest the blood glucose, the highest the amount of haemoglobin that is glycosilated. Considering the turnover rate of red blood cells, HbA1c reflects the mean blood glucose over the previous 8-10 weeks.
Which statement best describes the differences between the characteristics of type 1 and type 2 diabetes?
autoimmune factors are involved in the pathogenesis of type 1 but not type 2 diabetes
In type 1 diabetes, immunological factors cause the destruction of the beta cells, which leads to an absolute insulin deficiency; in fact, auto-antibodies against the beta-cell antigens are present in the blood of most patients with type 1 diabetes. In contrast, no immunological activation is present in type 2 diabetes.
According to trials on diabetes prevention, high-risk individuals can reduce their risk to develop diabetes by doing what?
Two intervention trials, one in the USA and the other in Finland, have clearly shown that a lifestyle intervention, including moderate weight reduction together with increased physical activity, reduction intake of saturated fat, and increased consumption of dietary fibre, is able to reduce the incidence of diabetes by 60% in high risk individuals.
Which of the following are the recommended blood pressure and lipid goals for the prevention of cardiovascular disease in adults with diabetes?
BP < 130/80, Trig <150, LDL < 100
The increased cardiovascular risk of diabetic patients is due to hyperglycaemia together with other cardiovascular risk factors such as, excess weight, insulin resistance, hypertension, lipid abnormalities. Thus, it is necessary to act not only on blood glucose control, but also on other risk factors to try to reach the best goals.
According to the recommendations for the nutritional management of patients with diabetes, the consumption of saturated fat should be:
a) <10% of total daily energy
A high intake of saturated fat is associated with an increase in LDL-cholesterol, blood pressure and insulin resistance. These effects are highly undesirable in diabetic patients who are known to be at higher cardiovascular risk compared to the general population.
The risk factors for type 1 diabetes include all of the following except?
Diet
Genetic
Autoimmune
Environmental
diet
Type 2 diabetes accounts for approximately what percentage of all cases of diabetes in adults?
C
Type 2 diabetes accounts for the overwhelming majority of cases diagnosed in adults. It develops gradually, beginning with insulin resistance and as the requirement for insulin increases, the pancreas becomes progressively less able to produce it.
Risk factors for type 2 diabetes include all of the following except?
Advanced age
Obesity
Smoking
Physical inactivity
C
Additional risk factors for type 2 diabetes are a family history of diabetes, impaired glucose metabolism, history of gestational diabetes, and race/ethnicity. African-Americans, Hispanics/Latinos, Asian Americans, Native Hawaiians, Pacific Islanders, and Native Americans are at greater risk of developing diabetes than whites.
Untreated diabetes may result in all of the following except:
Blindness
Cardiovascular disease
Kidney disease
Tinnitus
D
Untreated diabetes also may result in loss of lower limbs to amputation and death.
Prediabetes is associated with all of the following except:
Increased risk of developing type 2 diabetes
Impaired glucose tolerance
Increased risk of heart disease and stroke
Increased risk of developing type 1 diabetes
D
Persons with elevated glucose levels that do not yet meet the criteria for diabetes are considered to have prediabetes and are at increased risk of developing type 2 diabetes. Weight loss and increasing physical activity can help people with prediabetes prevent or postpone the onset of type 2 diabetes.
Diabetics are at increased risk of heart disease if they also:
Smoke
Have high HDL cholesterol levels
Take aspirin
Consume a high-fiber diet
A
Diabetics who smoke are at greater risk of developing heart disease because both diabetes and smoking act to narrow blood vessels. Smoking also is associated with increased risk of eye problems and may compromise circulation to the legs.
Blood sugar is well controlled when Hemoglobin A1C is:
Below 7%
Between 12%-15%
Less than 180 mg/dL
Between 90 and 130 mg/dL
A
A1c measures the percentage of hemoglobin that is glycated and determines average blood glucose during the two to three months prior to testing. Used as a diagnostic tool, A1C levels of 6.5% or higher on two tests indicate diabetes. A1C of 6% to 6.5% is considered prediabetes.
Excessive thirst and volume of very dilute urine may be symptoms of:
Urinary tract infection
Diabetes insipidus
Viral gastroenteritis
Hypoglycemia
B
Diabetes insipidus is a condition in which the kidneys are unable to conserve water, often because there is insufficient antidiuretic hormone (ADH) or the kidneys are unable to respond to ADH. Although diabetes mellitus may present with similar symptoms, the disorders are different. Diabetes insipidus does not involve hyperglycemia.
