Metabolic Diseases

Question 1

What do we NOT advise on nutrition after diabetes is diagnosed?
a. as little as possible of all carbohydrates
b. as many different vegetables as possible
c. avoiding white bread
d. as little fat as possible
e. avoiding simple sugars

Answer 1

a. as little as possible of all carbohydrates

Question 2

Metabolic syndrome is characterized by:
a. uremia
b. hyperinsulinemia
c. hypoinsulinemia
d. hyperglucagonemia
e. hypoglucagonemia

Answer 2

b. hyperinsulinemia

Question 3

Chronic hyperglycemia can be caused by:
a. hyperthyroidism
b. Cushing’s disease
c. acromegaly
d. pheochromocytoma
e. all of the above

Answer 3

e. all of the above

Question 4

The final secretions of the beta cell of the pancreas are:
a. insulin
b. insulin, C-peptide
c. insulin, C-peptide, proinsulin
d. insulin, C-peptide, proinsulin, preproinsulin
e. insulin, C-peptide, proinsulin, preproinsulin, glucose

Answer 4

c. insulin, C-peptide, proinsulin

Question 5

The recommended diet of a patient with diabetes includes:
a. 45-60% carbohydrates
b. 45-60% protein
c. 45-60% fat
d. lots of fiber

Answer 5

a. 45-60% carbohydrates
d. lots of fiber

Question 6

Lack of insulin in the body causes
a. lipolysis
b. central lipolysis, peripheral lipogenesis
c. increased gluconeogenesis
d. reduced gluconeogenesis
e. proteolysis
f. increased protein synthesis

Answer 6

a. lipolysis
c. increased gluconeogenesis
e. proteolysis

Question 7

Hyperglycemia in pregnancy can cause
a. fetal diabetes
b. hypoplasia of pancreatic beta cells
c. fetal anomalies
d. dehydration of the fetus
e. lack of amniotic sac

Answer 7

c. fetal anomalies

Question 8

Microalbuminuria:
a. It is a specific change in diabetic kidney disease
b. It means increased excretion of albumins in the urine
c. It means reduced excretion of albumins in the urine
d. It means the excretion of small albumins in the urine
e. It is a worse prognostic factor for the progression of renal disease in SB type 1
than in SB type 2

Answer 8

b. It means increased excretion of albumins in the urine

Question 9

Identify the correct statements
a. Diabetes is an etiologically heterogeneous disease.
b. Diabetes is often asymptomatic.
c. The level of glucose tolerance may vary in patients with impaired glucose
tolerance

Answer 9

All of them

Question 10

Diabetes occurs more often in the following disease:
a. albinism
b. Cushing’s syndrome
c. nephrotic syndrome
d. sarcoidosis
e. chronic inflammatory bowel disease

Answer 10

b. Cushing’s syndrome

Question 11

Choose the correct statements:
a. genetic defects in insulin action are an important mechanism of diabetes
b. many people with type 2 diabetes have undiagnosed diabetes
c. In the incidence of type 1 diabetes, Slovenia is at the very top among European
countries

Answer 11

b. many people with type 2 diabetes have undiagnosed diabetes

Question 12

C-peptide is characterized by:
a. It is secreted from the beta-cells of the pancreas
b. It is formed from a precursor molecule in the bloodstream
c. It is secreted in an equimolar amount as insulin
d. May act as an inhibitor of insulin action
e. The formation depends on the concentration of blood glucose

Answer 12

a. It is secreted from the beta-cells of the pancreas
c. It is secreted in an equimolar amount as insulin
e. The formation depends on the concentration of blood glucose

Question 13

Secretion of insulin from beta-cells of the pancreas accelerates:
a. glucose
b. fatty acids
c. ketones
d. amino acids

Answer 13

All of them

Question 14

Glucose stimulates the beta-cell of the pancreas to secrete insulin:
a. through diffusion
b. via active transport
c. via an osmotic gradient
d. via binding to a receptor on the beta cell membrane
e. via binding to the intracellular beta cell receptor

Answer 14

d. via binding to a receptor on the beta cell membrane

Question 15

The main target tissue for insulin action is:
a. muscle, liver, fat
b. heart, liver
c. heart and brain
d. kidneys
e. erythrocytes

Answer 15

a. muscle, liver, fat

Question 16

The strongest stimulus for the secretion of insulin from the beta cell of the pancreas is:
a. glucose
b. fatty acids
c. ketones
d. arginine
e. isoleucine

Answer 16

a. glucose

Question 17

Choose the correct statements about insulin:
a. when it is lacking, catabolism prevails
b. in its absence, anabolism prevails
c. hepatic insulin extraction is greater after feeding
d. hepatic insulin extraction is greater during starvation

Answer 17

a. when it is lacking, catabolism prevails
c. hepatic insulin extraction is greater after feeding

Question 18

Choose the correct statements about insulin:
a. It is excreted constantly
b. It is excreted after meals
c. The most important effect in the liver is the inhibition of lipolysis
d. The most important effect in the liver is the stimulation of lipolysis

Answer 18

a. It is excreted constantly
c. The most important effect in the liver is the inhibition of lipolysis

Question 19

Metabolic syndrome includes:
a. impaired glucose tolerance
b. diabetes
c. impaired glucose tolerance, increased blood pressure
d. impaired glucose tolerance, increased blood pressure, waist circumference
e. impaired glucose tolerance, increased blood pressure, waist circumference, visual disturbances,
increased plasma triglycerides

Answer 19

d. impaired glucose tolerance, increased blood pressure, waist circumference

Question 20

In the diet recommended for patients with diabetes, they represent the largest
share (energy)
a. liquid
b. fats
c. proteins
d. carbohydrates

Answer 20

d. carbohydrates

Question 21

Are diabetes patients more susceptible to infections?
a. Yes
b. no

Answer 21

a. Yes

Question 22

Do acute illnesses increase the need for insulin?
a. Yes
b. no

Answer 22

a. Yes

Question 23

Which patient is more likely to require hospital treatment for a urinary tract
infection?
a. DM type 1
b. DM type 2, which is treated with a maximum dose of oral antihyperglycemic agents

Answer 23

b. DM type 2, which is treated with a maximum dose of oral antihyperglycemic agents

Question 24

It applies to the diet of a patient with diabetes without chronic complications
a. may contain simple sugars that are added to the mixed meal, but the
maximum allowed amount is 5 g
b. it must not contain simple sugars
c. protein should dominate
d. it is desirable to consume as much fiber as possible

Answer 24

d. it is desirable to consume as much fiber as possible

Question 25

The most suitable diet for diabetes is:
a. a diet with as few carbohydrates as possible and as much protein as possible
b. a diet with as few carbohydrates and fats as possible and as much protein as possible
c. a diet with predominant components of fruits and vegetables
d. fasting diet
e. a diet based on healthy eating recommendations

Answer 25

e. a diet based on healthy eating recommendations

Question 26

Circle the correct statement about nutrition in diabetes.
a. Foods containing simple carbohydrates are absolutely forbidden.
b. Carbohydrate foods should be distributed at all daily meals.
c. We avoid foods with carbohydrates.
d. Vitamins and minerals are important energy foods in the diabetes diet.
e. Because of the impact on the complications caused by hyperglycemia, we advise each
patient to supplement with antioxidants and minerals.

Answer 26

b. Carbohydrate foods should be distributed at all daily meals.

Question 27

Type 1 diabetes is caused by
a. genetically conditioned pathological insulin molecules
b. destruction of beta cells due to autoimmune inflammation
c. destruction of beta cells in acute pancreatitis
d. changes in mitochondrial DNA
e. reduced regenerative abilities of pancreatic beta-cells

Answer 27

b. destruction of beta cells due to autoimmune inflammation

Question 28

Type 1 diabetes is characterized by
a. when the disease is detected, antibodies to antigens are present, which are components of
the membrane and cytoplasm of the beta cell
b. typically, the pathogenetic process lasts a maximum of several weeks before the appearance of clinical
signs
c. clinical manifestation of the disease with mild and uncharacteristic symptoms
d. when the disease is discovered, ketoacidosis may be present

Answer 28

a. when the disease is detected, antibodies to antigens are present, which are components of
the membrane and cytoplasm of the beta cell
d. when the disease is discovered, ketoacidosis may be present

Question 29

Type 1 diabetes is characterized by:
a. decreased function of the beta cells of the islets of Langerhans
b. increased insulin resistance
c. is more common than type 2 diabetes
d. in order to make a diagnosis, we perform tests on the most common antigens and
antibodies involved

Answer 29

a. decreased function of the beta cells of the islets of Langerhans

Question 30

Type 1 diabetes is characterized by:
a. great kinship tendency
b. autoimmune features
c. possible lifelong insulin dependence
d. complete concordance of monozygotic twins

Answer 30

b. autoimmune features
c. possible lifelong insulin dependence

Question 31

Type 1 diabetes applies to:
a. we see a seasonal variation in occurrence
b. we see a steady rise in incidence
c. a screening for it would be useful, but at the moment the health fund does not have
enough money
d. the peak of occurrence is in early childhood, when respiratory infections are also very common

Answer 31

a. we see a seasonal variation in occurrence
b. we see a steady rise in incidence

Question 32

Type 1 diabetes is characterized by:
a. is predominantly immune-induced
b. is predominantly idiopathic
c. when the disease manifested, almost 50% of the beta cells died
d. three-quarters of the beta cells have died at the onset of the disease
e. when the disease manifests, practically all beta cells are destroyed

Answer 32

a. is predominantly immune-induced
d. three-quarters of the beta cells have died at the onset of the disease

Question 33

In type 1 diabetes:
a. in addition to the islets of Langerhans, the exocrine pancreatic function is
often affected
b. apart from the islets of Langerhans, there is no characteristic impairment of the exocrine
pancreatic function
c. glucagon secretion is often affected in addition to the islets of Langerhans
d. glucagon secretion is not affected
e. the secretion of somatostatin is often affected due to the cytotoxic tissue
response

Answer 33

b. apart from the islets of Langerhans, there is no characteristic impairment of the exocrine
pancreatic function
d. glucagon secretion is not affected

Question 34

Type 1 diabetes is characterized by an antibody:
a. ACE
b. MPO
c. NASTY
d. Ttg
e. EMA

Answer 34

c. NASTY

Question 35

Newly diagnosed type 1 diabetes is clinically expressed by:
a. polyuria
b. oliguria
c. nocturia
d. weight reduction
e. weight gain

Answer 35

a. polyuria
c. nocturia
d. weight reduction

Question 36

In type 2 diabetes we find:
a. albuminuria
b. hematuria
c. hypercalcemia

Answer 36

a. albuminuria

Question 37

Type 2 diabetes is characterized by:
a. Insulin secretion is insufficient in every phase of the disease
b. Insulin secretion is sufficient in the initial stages, but then it decreases and becomes
insufficient
c. Insulin secretion is sufficient in all phases of the disease, hyperglycemia is the
result of insulin resistance
d. Insulin secretion is sufficient in all stages of the disease, hyperglycemia is the result of
uncontrolled hepatic gluconeogenesis
e. Insulin secretion is sufficient, but hyperglycemia is the result of both uncontrolled
hepatic gluconeogenesis and reduced responsiveness of fat and muscle to preexisting insulin

Answer 37

a. Insulin secretion is insufficient in every phase of the disease

Question 38

What is specific about DM 2:
a. US small kidney
b. nephrotic syndrome
c. increased albuminuria

Answer 38

c. increased albuminuria

Question 39

Untreated or newly diagnosed type 2 diabetes is clinically expressed by:
a. Polyuria
b. Oliguria
c. Nocturia
d. By reducing body weight
e. By increasing body weight

Answer 39

a. Polyuria
c. Nocturia
d. By reducing body weight

Question 40

Patients with type 2 diabetes usually have the following characteristics:
a. under 40 years old
b. overweight
c. when the disease occurs, insulin secretion is insufficient
d. at the onset of the disease, insulin secretion is still present
e. family tendency

Answer 40

b. overweight
c. when the disease occurs, insulin secretion is insufficient
d. at the onset of the disease, insulin secretion is still present
e. family tendency

Question 41

The basis of successful treatment of type 2 diabetes is
a. metformin
b. healthy balanced diet
c. insulin replacement
d. adequate hydration
e. combination therapy with metformin and a sulfonylurea

Answer 41

b. healthy balanced diet

Question 42

Type 2 diabetes is characterized by:
a. tends to metabolic deterioration despite treatment
b. familial occurrence is not pronounced
c. when it appears, it manifests itself with a turbulent clinical picture
d. insulin secretion is not impaired
e. often occurs after frequent pancreatitis

Answer 42

a. tends to metabolic deterioration despite treatment

Question 43

Type 2 diabetes applies to:
a. the incidence of occurrence is highest after the age of 65
b. the incidence is decreasing due to good prevention
c. pancreatic beta cell dysfunction has a characteristic tendency to worsen
d. an important risk factor for its occurrence is obesity

Answer 43

c. pancreatic beta cell dysfunction has a characteristic tendency to worsen
d. an important risk factor for its occurrence is obesity

Question 44

Type 2 diabetes is characterized by:
a. the onset of the disease is sudden
b. etiopathogenesis is similar to impaired glucose tolerance
c. etiopathogenesis is similar to that of borderline basal glycemia
d. when diabetes develops, hyperinsulinemia may still be present

Answer 44

b. etiopathogenesis is similar to impaired glucose tolerance
d. when diabetes develops, hyperinsulinemia may still be present

Question 45

Type 2 diabetes applies to:
a. it is a clinically homogeneous disease
b. it is a clinically heterogeneous disease
c. insulin responsiveness is impaired at both the postreceptor and prereceptor
levels
d. there is also always a defect in insulin secretion

Answer 45

b. it is a clinically heterogeneous disease

Question 46

Type 2 diabetes applies to:
a. Slovenia has a lower disability than neighboring countries
b. Slovenia has a similar vulnerability to neighboring countries
c. It is more common in women
d. When discovered, it is mostly symptomatic

Answer 46

b. Slovenia has a similar vulnerability to neighboring countries
c. It is more common in women

Question 47

MODY is:
a. form of type 1 diabetes
b. form of type 2 diabetes
c. a more severe course of diabetes is typical
d. a milder course of diabetes is typical

Answer 47

b. form of type 2 diabetes
d. a milder course of diabetes is typical

Question 48

Type 2 diabetes:
a. is caused by a reduced ability to secrete insulin
b. upon discovery, all patients have symptomatic hyperglycemia
c. upon discovery, signs of involvement of the large vessels can be identified
d. upon discovery, signs of microangiopathy can be identified

Answer 48

a. is caused by a reduced ability to secrete insulin
c. upon discovery, signs of involvement of the large vessels can be identified
d. upon discovery, signs of microangiopathy can be identified

Question 49

Type 2 diabetes is characterized by:
a. insulin secretion in the basal state is somewhat weaker in obese people
b. insulin secretion in the basal state is stronger in obese people
c. with the increase in glucose concentration after exercise, the secretion of insulin from
the pancreas increases proportionally
d. as the concentration of glucose increases after exercise, the secretion of insulin from
the pancreas decreases proportionally

Answer 49

b. insulin secretion in the basal state is stronger in obese people
c. with the increase in glucose concentration after exercise, the secretion of insulin from
the pancreas increases proportionally

Question 50

Type 2 diabetes
a. there is no beta cell damage, but the primary pathogenesis is increased tissue resistance
b. mostly in obese people
c. can’t get skinny people

Answer 50

a. there is no beta cell damage, but the primary pathogenesis is increased tissue resistance
b. mostly in obese people

Question 51

The drug of choice for the initiation of treatment for type 2 diabetes is
a. metformin
b. insulin secretagogue
c. a drug that acts on the incretin system
d. insulin

Answer 51

a. metformin

Question 52

For most patients with type 2 diabetes, the target HbA1c is
a. below 8.0%
b. below 6.5%
c. below 7.5%
d. below 7.0%

Answer 52

d. below 7.0%

Question 53

Hyperglycemia in pregnancy can cause:
a. fetal diabetes
b. hypoplasia of pancreatic beta cells
c. fetal anomalies
d. dehydration of the fetus
e. lack of amniotic sac

Answer 53

c. fetal anomalies

Question 54

Pregnancy DM is usually treated with:
a. diet and, if necessary, insulin
b. diet and, if necessary, with metformin
c. diet and, if necessary, herbal teas
d. only with a diet, because as a rule it is mild
e. diet and, if necessary, a sulfonylurea

Answer 54

a. diet and, if necessary, insulin

Question 55

Choose the correct statements.
a. Pre-existing diabetic retinopathy and diabetic nephropathy can be
expected to worsen during pregnancy
b. Diabetes may reoccur during pregnancy, but glucose tolerance
normalizes after delivery.
c. Women who have had gestational diabetes have a high risk of developing type
1 diabetes.

Answer 55

a. Pre-existing diabetic retinopathy and diabetic nephropathy can be
expected to worsen during pregnancy
b. Diabetes may reoccur during pregnancy, but glucose tolerance
normalizes after delivery.

Question 56

Circle the correct statements:
a. Diabetic retinopathy can worsen during pregnancy.
b. Diabetic nephropathy can worsen during pregnancy.
c. Hyperglycemia in pregnancy can cause diabetic fetopathy.
d. Hyperglycemia causes a higher number of late intrauterine deaths.

Answer 56

All of them

Question 57

Circle the correct answers:
a. gestational diabetes is a risk factor for the later development of type 2
diabetes in the mother
b. diabetes in pregnancy is a risk factor for the later development of type 2
diabetes in the child
c. stricter control of the fetus in a mother with gestational diabetes is necessary
especially in the first trimester of pregnancy
d. untreated or poorly treated diabetes in pregnancy causes microsomia.

Answer 57

a. gestational diabetes is a risk factor for the later development of type 2
diabetes in the mother
b. diabetes in pregnancy is a risk factor for the later development of type 2
diabetes in the child

Question 58

Circle the correct answers regarding diabetes in pregnancy.
a. Glucose passes into the placenta by active transport.
b. Maternal hyperglycemia causes pancreatic B cell hyperplasia in the child
and may cause hypoglycemia in the newborn.
c. Both hyperglycemia and hypoglycemia in early pregnancy are teratogenic.

Answer 58

b. Maternal hyperglycemia causes pancreatic B cell hyperplasia in the child
and may cause hypoglycemia in the newborn.

Question 59

Why is diabetes in pregnancy a threat to the child?
a. due to the presence of glycemia
b. due to a higher concentration of insulin in the mother
c. due to a lower concentration of growth hormone in the mother

Answer 59

a. due to the presence of glycemia

Question 60

Which pregnant women have a higher risk of developing malformations in the child?
a. those with frequent hypoglycemia
b. those with high HbA1c
c. those with a high daily dose of insulin

Answer 60

b. those with high HbA1c

Question 61

When do malformations occur during embryonic development?
a. in the first 8 weeks
b. between the 20th and 30th week
c. between 10 and 15 weeks

Answer 61

a. in the first 8 weeks

Question 62

Does pregnancy increase the risk of hypoglycemia in the first few weeks of pregnancy?
a. Yes
b. no

Answer 62

a. Yes

Question 63

Does pregnancy increase the risk of progression of microvascular chronic complications of
DM?
a. Yes
b. no

Answer 63

a. Yes

Question 64

Why is it necessary to add folic acid before and during pregnancy?
a. to prevent hypertension in pregnancy
b. to prevent fetal growth retardation
c. to prevent spina bifida

Answer 64

c. to prevent spina bifida

Question 65

The way we look for pregnant women with pathological glycemia:
a. screening

Answer 65

a. screening

Question 66

Hyperglycemia in the mother can cause hypoglycemia/hyperglicemia in a newborn.

Answer 66

hypoglicemia

Question 67

The most characteristic malformation in mothers with DM type 1:
a. caudal regression.

Answer 67

a. caudal regression.

Question 68

Method of delivery, which is more common in patients with hyperglycemia in pregnancy:
a. Caesarean section.

Answer 68

a. Caesarean section.

Question 69

Part of the body of the fetus, the extent of which most reflects the harmful consequences of hyperglycemia:
a.belly.

Answer 69

a.belly.

Question 70

The most common cause of death of a pregnant woman with long-lasting diabetes is
-acute
myocardial infarction.

Answer 70

-acute
myocardial infarction.

Question 71

Which medicinesthey are not insulin secretagogues?
a. sulfonylurea
b. meglitinides
c. metformin
d. DPP-4 inhibitors
e. SGLT-2 inhibitors
f. acarbose
g. thiazolidinedione

Answer 71

c. metformin
d. DPP-4 inhibitors
e. SGLT-2 inhibitors
f. acarbose
g. thiazolidinedione

Question 72

When is metformin contraindicated?
a. after an acute heart attack
b. low oGF values
c. high oGF values
d. in obese people
e. in skinny people people

Answer 72

a. after an acute heart attack
b. low oGF values

Question 73

Correct statement about metformin:
a. first choice for type 2 diabetes
b. has severe side effects, therefore very rarely indicated
c. it is used with benefit in patients with type 1 diabetes
d. GIT side effects manifest as ulcer disease

Answer 73

a. first choice for type 2 diabetes

Question 74

How do we regulate glycemia in a person who does not eat or drink per os:
a. rapid-acting insulin sc
b. short-acting insulin is administered via an insulin pump
c. IV insulin boluses are administered.

Answer 74

b. short-acting insulin is administered via an insulin pump

Question 75

Which of the following should we consider when choosing antidiabetic therapy?
a. The effectiveness of the drug
b. Risk of hypoglycemia
c. Body weight
d. Side effects of the drug
e. The price of the drug

Answer 75

All of them

Question 76

Medicines from the group of sulfonylureas can be combined with:
a. Insuline
b. DPP-4 inhibitors
c. Metformin
d. To all of the above
e. None of the above

Answer 76

d. To all of the above

Question 77

When introducing insulin therapy, we calculate the approximate initial daily dose based
on:
a. BMI
b. Fasting and postprandial plasma glucose concentrations
c. Body weight
d. Carbohydrate content in food
e. Prior oral therapies

Answer 77

c. Body weight

Question 78

Which of the listed insulin preparations doesn’t belongs to insulin analogues?
a. Lispro
b. Apidra
c. NPH
d. Aspart
e. Glargine

Answer 78

c. NPH

Question 79

The most common side effect of insulin treatment is
a. local lipodystrophy
b. hypersensitivity reaction
c. hypoglycemia
d. insulin edema
e. hirsutism

Answer 79

c. hypoglycemia

Question 80

Stimulators of insulin secretion are the following drugs:
a. metformin
b. sulfonylurea
c. acarbose
d. methylprednisolone

Answer 80

b. sulfonylurea

Question 81

During surgery, a patient with diabetes treated at home with sulfonylurea can
receive:
a. sulfonylurea subcutaneously
b. sulfonylurea intravenously
c. insulin subcutaneously
d. insulin intravenously
e. should not receive any therapy to avoid unrecognized hypoglycemia

Answer 81

d. insulin intravenously

Question 82

Metformin can cause lactic acidosis in a patient with:
a. severe ischemic heart disease
b. advanced chronic kidney disease
c. advanced chronic liver disease
d. severe chronic obstructive pulmonary disease
e. all the listed diseases

Answer 82

b. advanced chronic kidney disease

Question 83

The most common complication of metformin treatment is:
a. lactic acidosis
b. arterial hypertension
c. gynecomastia
d. deterioration of kidney function
e. diarrhea

Answer 83

e. diarrhea

Question 84

Metformin:
a. is known for frequent life-threatening side effects
b. is the drug with the least side effects for the treatment of type 2 diabetes
c. causes kidney failure
d. is excreted mainly through the liver
e. no answer is correct

Answer 84

b. is the drug with the least side effects for the treatment of type 2 diabetes

Question 85

Metformin:
a. is the drug of first choice for the treatment of type 2 diabetes
b. due to numerous side effects, we decide to introduce it only in a selected
patient population
c. due to dangerous side effects and a narrow therapeutic window, its concentration
in the blood is regularly monitored
d. it is also used with benefit in patients with type 1 diabetes
e. gastrointestinal side effects often lead to upper gastrointestinal ulcers

Answer 85

a. is the drug of first choice for the treatment of type 2 diabetes

Question 86

Medicines from the group of sulfonylureas can be combined with:
a. insulinoma
b. acarbose
c. metformin
d. with all of the above
e. with none of the above

Answer 86

d. with all of the above

Question 87

The normal functioning of the pancreas in diabetes is best mimicked by treatment
with a combination of:
a. two intermediate-acting insulins
b. human short-acting insulin and ultra-short-acting insulin
c. short-acting and medium- to long-acting insulin
d. intermediate- and long-acting insulin
e. oral therapies with ultrashort-acting insulin

Answer 87

c. short-acting and medium- to long-acting insulin

Question 88

Hypersensitivity to insulin:
a. is a very rare complication of insulin treatment
b. is a very common complication of insulin treatment
c. it is most often manifested as a local reaction
d. most often manifests as a systemic reaction
e. it is more common in obese patients

Answer 88

a. is a very rare complication of insulin treatment
c. it is most often manifested as a local reaction

Question 89

Insulin edema:
a. occur rarely with insulin treatment
b. often occur during insulin treatment
c. most of the time no treatment is necessary
d. In most cases, several days of aggressive treatment with a diuretic is required, so
patients are usually hospitalized
e. it is a direct effect of insulin that causes sodium retention in the body.

Answer 89

a. occur rarely with insulin treatment
c. most of the time no treatment is necessary
e. it is a direct effect of insulin that causes sodium retention in the body.

Question 90

Antihypertensives that worsen glucose tolerance are:
a. thiazide diuretics
b. alpha receptor blockers
c. angiotensin receptor antagonists
d. calcium antagonists
e. angiotensin converting enzyme inhibitors

Answer 90

a. thiazide diuretics

Question 91

Sulfonylureas:
a. they do not cause severe hypoglycemia
b. they work by reducing insulin resistance
c. stimulate the production of insulin
d. stimulate the exocytosis of insulin from the pancreas
e. are safe drugs, even in chronic kidney disease

Answer 91

d. stimulate the exocytosis of insulin from the pancreas

Question 92

Sulfonylureas:
a. they can be safely used to treat gestational diabetes
b. may cause hypoglycemia
c. they can be used in both type 1 and type 2 diabetes
d. they have frequent side effects and are therefore very rarely used in treatment
e. it is necessary to regularly monitor drug levels in plasma

Answer 92

b. may cause hypoglycemia

Question 93

Hypoglycemia with sulfonylurea:
a. usually requires hospitalization
b. the most dangerous are preparations with a short-term but intense effect
c. they are common in kidney failure
d. in case of diarrhea or vomiting or fasting, sulfonylureas are not taken for
fear of hypoglycemia

Answer 93

a. usually requires hospitalization
c. they are common in kidney failure
d. in case of diarrhea or vomiting or fasting, sulfonylureas are not taken for
fear of hypoglycemia

Question 94

Metformin is a widely used drug, but it is contraindicated in:
a. extensive ischemia of the lower extremities
b. chronic kidney disease
c. severe liver damage
d. severe anemia
e. frequent severe asthmatic attacks

Answer 94

All of them

Question 95

The most dangerous side effect of sulfonylurea is:
a. renal failure
b. acute myocardial infarction
c. liver failure
d. hypoglycemia
e. allergy

Answer 95

d. hypoglycemia

Question 96

What is the concentration of insulin in the preparations available in Slovenia:
a. 1 U/ml
b. 4 U/ml
c. 40 U/ml
d. 100 U/ml
e. 400 U/ml

Answer 96

d. 100 U/ml

Question 97

The following applies to the treatment of diabetes with an insulin pump:
a. we recommend it especially to young patients
b. it is recommended especially for patients with type 2 diabetes
c. awareness of hypoglycemia is a necessary condition for treatment
d. increases the risk of ketoacidosis
e. we recommend it to all pregnant women with diabetes

Answer 97

d. increases the risk of ketoacidosis

Question 98

The following applies to the treatment of diabetes with an insulin pump:
a. It is contraindicated in infants
b. The pump is already able to advise the patient on glycemic control
c. it involves continuous intravenous administration of small amounts of insulin
d. it is suitable for the application of prandial, but not correction doses of insulin
e. compared to injectors, there is a lower risk of hyperglycemia

Answer 98

b. The pump is already able to advise the patient on glycemic control

Question 99

Insulin treatment:
a. in type 2 diabetes it is only required exceptionally
b. we introduce it exclusively in hospitals
c. the basic dose of insulin in type 1 diabetes is 0.6-0.8 U/kg body weight
d. with biphasic insulins, as a rule, glycemia is regulated more precisely than with basal
and prandial insulins
e. in combination with oral therapy is contraindicated

Answer 99

c. the basic dose of insulin in type 1 diabetes is 0.6-0.8 U/kg body weight

Question 100

A basal-bolus insulin regimen means that the patient uses
a. one application of biphasic insulin at breakfast and one application at dinner
b. intermediate-acting insulin at bedtime with concomitant oral therapy
c. three applications of biphasic insulin daily
d. long-acting or intermediate-acting insulin to cover basal needs and shortacting or ultra-short-acting insulin at each meal

Answer 100

d. long-acting or intermediate-acting insulin to cover basal needs and shortacting or ultra-short-acting insulin at each meal

Question 101

It is most important to prevent chronic complications of diabetes
a. multifactorial treatment
b. treatment of dyslipidemia
c. treatment of arterial hypertension
d. treatment of elevated glycemia

Answer 101

a. multifactorial treatment

Question 102

To cover the insulin needs of one meal, the most appropriate insulin
a. an ultrashort-acting insulin analogue
b. short-acting human insulin
c. long-acting insulin analogue
d. biphasic insulin

Answer 102

a. an ultrashort-acting insulin analogue

Question 103

A conventional insulin regimen is:
a. NPH insulin morning and evening short-acting after meals
b. insulin with a sulfonylurea
c. insulin in the morning and in the evening
d. insulin in combination with metformin

Answer 103

c. insulin in the morning and in the evening

Question 104

Which distribution of insulins is the most important from a clinical point of view?
a. by operating time (short-acting, long-acting)
b. after filling (vials, carpules, pre-filled injectors)
c. by origin (animal, biosynthetic)
d. according to the concentration of the preparation (100 U/ml, 40 U/ml)

Answer 104

a. by operating time (short-acting, long-acting)

Question 105

Which of the following patients would you start a basal-bolus insulin regimen?
a. 77-year-old retired mathematics professor, SB 2 17 years, HbA1c 9.8% on Glucovance 500/5
mg 3x 1tbl, visually impaired due to macular degeneration and therefore no longer has a
driver’s license, lives with his wife, who also cooks for him. He spends the summer with his
wife in a caravan on the coast.
b. 50-year-old commercial woman, DM type 2 for five years, HbA1c 7.9% with
Novonorm 3x 4 mg and Aglurab 3x 850 mg, she goes on a business trip abroad
at least once a month, usually on a long trip on annual leave
c. 84-year-old retired nurse, DM type 2 for 25 years, with Glurenorm and Aglurab HbA1c
12%. He lives in DSO, goes for an hour’s walk every day, once a year for a week in
Strunjan. He takes the therapy in the DSO independently, without the help of the
home staff.
d. 71-year-old retired seamstress, type 2 diabetes for 15 years, last five years on
combined therapy with Diaprel and Aglurab, HbA1c 9%. She lives with her husband,
cooks herself, meals more or less at the same time every day, twice a year she and
her husband go to the spa for a week.

Answer 105

b. 50-year-old commercial woman, DM type 2 for five years, HbA1c 7.9% with
Novonorm 3x 4 mg and Aglurab 3x 850 mg, she goes on a business trip abroad
at least once a month, usually on a long trip on annual leave

Question 106

On the basis of which parameter is the initial dose of insulin determined?
a. according to blood sugar before bed
b. according to fasting blood sugar
c. according to body weight
d. according to the number of food portions and their quantitative and qualitative composition

Answer 106

c. according to body weight

Question 107

The calculated daily energy requirement is generally higher in diabetic patients
who are not treated with insulin than in people without diabetes
a. True
b. It’s not true

Answer 107

b. It’s not true

Question 108

Sulfonylurea preparations are the first therapy of choice for obese patients
a. True
b. It’s not true

Answer 108

b. It’s not true

Question 109

To cover the insulin needs of one meal, the most appropriate insulin
a. short-acting human insulin
b. long-acting insulin analogue
c. an ultrashort-acting insulin analogue
d. biphasic insulin

Answer 109

c. an ultrashort-acting insulin analogue

Question 110

How should patients adjust insulin doses themselves?
a. patients should not change the doses themselves, but should give themselves the doses ordered
by the doctor during the outpatient check-up
b. patients should not change the doses themselves, except when not eating or if they
skip a meal in preparation for an examination (US, gastroscopy, etc.) - in this case,
they should skip the dose.
c. based on the currently measured value according to the principle of sliding doses: for a low
value, the dose is reduced or omitted, for a high value, the dose is increased to a
maximum of double the initial
d. based on the dynamics of glycemia in the daily profile according to the cause-effect
principle

Answer 110

d. based on the dynamics of glycemia in the daily profile according to the cause-effect
principle

Question 111

When treating with metformin, we fear the most:
a. hypoglycemia
b. exacerbation of renal impairment
c. ketoacidosis
d. lactic acidosis
e. obesity

Answer 111

d. lactic acidosis

Question 112

Acarbose:
a. contraindication is chronic inflammatory bowel disease
b. it can be used to treat all types of diabetes, including gestational diabetes
c. practically no side effects
d. in monotherapy, it can effectively control glycemia in the long term
e. affects primarily basal glycemia

Answer 112

a. contraindication is chronic inflammatory bowel disease

Question 113

Screening test for diabetic retinopathy:
a. Imaging of the fundus camera
b. Laboratory monitoring
c. Pinhole inspection
d. Visus, fundus and campus examination
e. Vascular imaging with fluorescence technique

Answer 113

a. Imaging of the fundus camera

Question 114

What is the basic examination to assess the arterial circulation of the legs?
a. Sensation of hot/cold
b. Palpation of pulses a. dorsalis pedis and a. tibialis posterior
c. Measurement of perfusion pressures at the ankle and calculation of the ankle index
d. Angiography
e. Oximetry

Answer 114

b. Palpation of pulses a. dorsalis pedis and a. tibialis posterior

Question 115

The oral glucose tolerance test is performed:
a. after three days of a proper diabetic diet
b. after 8-12 hours of starvation
c. after breakfast
d. the day before the test, avoid foods containing carbohydrates and saturated
fatty acids

Answer 115

b. after 8-12 hours of starvation

Question 116

Determination of microalbuminuria:
a. it is determined only if macroalbuminuria is detected
b. the result is reliable only if it is determined in the collected 24-hour urine
c. with normal excretion of albumin in the urine, the examination is repeated every 5 years
d. none of the above

Answer 116

d. none of the above

Question 117

The only accurate way to diagnose diabetes is:
a. determination of fasting glucose
b. oral glucose tolerance test
c. the presence of clinical symptoms and signs of hyperglycemia

Answer 117

a. determination of fasting glucose
b. oral glucose tolerance test

Question 118

Choose the correct statements.
a. The borderline values between the pathological and normal range of glycemia were determined
according to the occurrence of microangiopathy.
b. The borderline values between the pathological and normal range of glycemia were determined
according to the occurrence of macroangiopathy.
c. The standard way to diagnose diabetes is to measure fasting blood
glucose.
d. People with impaired glucose tolerance are characterized by a higher risk of
developing microangiopathic complications.

Answer 118

A,c,d

Question 119

In an asymptomatic person, it is sufficient for the diagnosis of diabetes
a. two fasting glucose measurements of 7.0 mmol/l or more on two different days
b. one fasting glucose measurement of 7.0 mmol/l or more and glycosuria
c. one fasting glucose measurement of 7.0 mmol/l or more
d. one measurement with a convenient glucose meter that patients use at home
(glucometer) 7.0 mmol/l or more

Answer 119

a. two fasting glucose measurements of 7.0 mmol/l or more on two different days

Question 120

Impaired glucose tolerance is tested:
a. Fasting
b. 120 min after OGTT
c. After breakfast
d. Immediately after the glucose load

Answer 120

b. 120 min after OGTT

Question 121

Choose the correct statements:
a. With DM1, we test for chronic complications immediately upon diagnosis
b. In DM1, we test for chronic complications 5 years after diagnosis
c. With DM2, we test for chronic complications immediately upon diagnosis
d. All diabetic patients are tested for chronic complications every year

Answer 121

B,C,D

Question 122

An OGTT is performed on a person and the results are obtained: immediately after drinking the drink, the glucose is
6.8 mmol/l, after 120 minutes the glucose is 9.8 mmol/l. What is it?
a. impaired glucose tolerance,
b. borderline basal glycemia
c. Diabetes
d. he is healthy

Answer 122

a. impaired glucose tolerance,
b. borderline basal glycemia

Question 123

A 42-year-old patient has a fasting blood glucose value of 4.5 mmol/l after an oral glucose
tolerance test, and 10.0 mmol/l in the 120th minute. The patient most likely has:
a. Limit basal glycemia
b. Diabetes
c. Normoglycemia
d. Impaired glucose tolerance
e. Hereditary glycogenosis

Answer 123

d. Impaired glucose tolerance

Question 124

An 80-year-old man’s fasting blood sugar was measured at 7.5 and 7.4 mmol/l on two
different occasions. Circle the most correct statement
a. The gentleman is normoglycemic.
b. The gentleman has borderline basal glycemia.
c. The gentleman has impaired glucose tolerance.
d. The gentleman has senile diabetes that does not require further action.
e. The gentleman has diabetes.

Answer 124

e. The gentleman has diabetes.

Question 125

Assessment of possible chronic complications of diabetes is carried out:
a. when type 1 diabetes is diagnosed
b. five years after being diagnosed with type 1 diabetes
c. five years after being diagnosed with type 2 diabetes
d. every year, regardless of the type of diabetes
e. only with pronounced symptoms of peripheral organ damage, since complications cannot be
cured, we can only alleviate the symptoms

Answer 125

b. five years after being diagnosed with type 1 diabetes

Question 126

How to test important defense/basal sensation in diabetics
a. the screening test for its detection is the Semmes-Weinstein
monofilament test

Answer 126

a. the screening test for its detection is the Semmes-Weinstein
monofilament test

Question 127

Diabetic ketoacidosis occurs more often in:
a. to a demented patient
b. to a young patient
c. to an overfed patient
d. to a normally fed patient
e. malnourished patient

Answer 127

b. to a young patient
d. to a normally fed patient

Question 127

The most common triggering factor for diabetic ketoacidosis is:
a. inadequate insulin dosage
b. discontinuation of insulin treatment
c. newly diagnosed diabetes
d. infection
e. treatment with corticosteroids

Answer 127

d. infection

Question 128

In the treatment of diabetic aketotic hyperosmolar syndrome, in the first hour in
the absence of significant heart failure, the correct rate of replacement of crystalloid
solutions
a. 50 ml
b. 100 ml
c. 200 ml
d. 1000 ml
e. 2000 ml.

Answer 128

d. 1000 ml

Question 129

Treatment of acute complications of diabetes requires:
a. insulin replacement
b. fluid replacement
c. electrolyte replacement
d. correction of acidosis
e. prevention of thromboembolism

Answer 129

All of them

Question 130

Which symptoms are characteristic of DAHS?
a. abdominal pain
b. hypothermia
c. very high blood glucose levels
d. dehydration
e. moderately increased nitrogen retention

Answer 130

b. hypothermia
c. very high blood glucose levels
d. dehydration

Question 131

The following applies to DAHS:
a. he is treated with sc long-acting insulin
b. he is treated with sc short-acting insulin
c. it is treated with long-acting insulin iv
d. it is treated with boluses of short-acting insulin IV
e. it is treated with an infusion of short-acting insulin

Answer 131

e. it is treated with an infusion of short-acting insulin

Question 132

The following applies to ketoacidosis:
a. is the result of unrestrained lipolysis
b. is the result of unrestrained gluconeogenesis
c. does not occur in type 2 diabetes
d. the leading metabolic process is anabolism

Answer 132

a. is the result of unrestrained lipolysis

Question 132

Diabetic autonomic neuropathy is characterized by:
a. occurs with more than 20 years of diabetes duration
b. associated with high mortality
c. is one of the most studied complications of diabetes
d. the diagnosis is made on the basis of a neurological physical examination
e. the screening test for its detection is the Semmes-Weinstein monofilament
test

Answer 132

b. associated with high mortality
d. the diagnosis is made on the basis of a neurological physical examination

Question 133

What is autonomic diabetic neuropathy?
a. Appears early
b. Death due to rhythm disturbances
c. Erectile dysfunction and nocturnal diarrhea
d. Orostatic hypotension and chronic bradycardia
e. Diabetic neuropathy can only be determined by excluding other causes

Answer 133

b. Death due to rhythm disturbances
c. Erectile dysfunction and nocturnal diarrhea
d. Orostatic hypotension and chronic bradycardia
e. Diabetic neuropathy can only be determined by excluding other causes

Question 134

What isn’t considered an ischemic leg ulcer in diabetes?
a. It is dry necrosis
b. Hyperkeratotic margin
c. Ulcer under the 3rd metatarsal
d. Ulcer on the contact surface of the 4th and 5th finger
e. Anthills at rest
f. Pain in the limb after walking 500 m

Answer 134

b. Hyperkeratotic margin
c. Ulcer under the 3rd metatarsal
e. Anthills at rest

Question 135

Progression of diabetic retinopathy doesn’t speed up:
a. arterial hypertension
b. acute myocardial infarction
c. renal failure
d. rapid lowering of blood glucose
e. pregnancy

Answer 135

b. acute myocardial infarction
d. rapid lowering of blood glucose

Question 136

Diabetic retinopathy
a. is due to angiopathy
b. is due to neuropathy
c. we look for it in the discovery of type 1 diabetes
d. we look for it in the discovery of type 2 diabetes

Answer 136

a. is due to angiopathy
d. we look for it in the discovery of type 2 diabetes

Question 137

Diabetic nephropathy. Circle the wrong answer:
a. almost all patients have diabetic retinopathy
b. before starting treatment, we need accurate imaging and histological
diagnosis
c. in patients with type 1 diabetes, we start determining the excretion of albumin in
the urine as a screening test only 5 years after the diagnosis of diabetes, and in
patients with type 2 diabetes immediately after the diagnosis of diabetes
d. well-controlled diabetes can play a role in slowing down the disease
e. smoking directly affects the deterioration of kidney function

Answer 137

b. before starting treatment, we need accurate imaging and histological
diagnosis

Question 138

Circle the correct statements regarding diabetic kidney disease.
a. the appearance of microalbuminuria is a sure sign of early diabetic
kidney disease in type 1 diabetes
b. the appearance of microalbuminuria is a reliable sign of early diabetic kidney
disease in type 2 diabetes
c. proteinuria is a basic sign of diabetic kidney disease
d. hematuria is the basic sign of diabetic kidney disease

Answer 138

a. the appearance of microalbuminuria is a sure sign of early diabetic
kidney disease in type 1 diabetes
c. proteinuria is a basic sign of diabetic kidney disease

Question 139

What type of nerve damageit is not characteristic of diabetes?
a. spastic hemiparesis
b. carpal tunnel syndrome
c. autonomic neuropathy
d. symmetrical sensorimotor neuropathy
e. symmetrical proximal neuropathy of the lower limbs

Answer 139

a. spastic hemiparesis

Question 140

The most common cause of death in a diabetic patient is:
a. diabetic ketoacidosis
b. diabetic kidney disease
c. diabetic polyneuropathy
d. macroangiopathy
e. malignant

Answer 140

d. macroangiopathy

Question 141

Circle the specific complication of diabetes:
a. acute myocardial infarction
b. diabetic cardiomyopathy
c. diabetic nephropathy
d. Charcot foot
e. cerebrovascular insult

Answer 141

c. diabetic nephropathy

Question 142

The diagnosis of diabetic kidney disease is very likely if
a. diabetes lasts more than 5 years
b. diabetic retinopathy is present
c. constant proteinuria is more than 0.5 g/day
d. arterial hypertension is present
e. frequent urinary tract infections are absent

Answer 142

A,B,C,E

Question 143

Circle the correct statements regarding diabetic kidney disease.
a. the appearance of microalbuminuria is a very likely sign of early diabetic
kidney disease in type 2 diabetes
b. proteinuria is a common sign of diabetic kidney disease
c. hematuria is a common sign of diabetic kidney disease
d. patients with hematuria have the shortest survival

Answer 143

b. proteinuria is a common sign of diabetic kidney disease

Question 144

Autonomic neuropathy in diabetes.
a. half of patients with autonomic neuropathy die within the first year of
diagnosis
b. autonomic disorders include erectile dysfunction and nocturnal diarrhea
c. patients may have persistent bradycardia or postural hypotension
d. patients with this complication are most at risk of sudden heart rhythm disturbances

Answer 144

B,C,D

Question 145

The peculiarity of coronary disease in diabetes is:
a. the absence of typical changes in the ECG
b. absence of typical chest pain
c. the absence of an increase in heart muscle breakdown enzymes
d. poorer response to nitroglycerin treatment
e. poorer response to beta-blocker therapy

Answer 145

b. absence of typical chest pain

Question 146

Circle the correct statements regarding the macrovascular complications of diabetes
a. women develop them more often than men
b. due to the high risk of macrovascular complications, antiplatelet protection is
recommended for all patients with diabetes
c. the probability of coronary heart disease is higher in the presence of renal
involvement
d. atherosclerosis covers a larger area of the arterial vessel as well as vessels of
smaller caliber

Answer 146

c. the probability of coronary heart disease is higher in the presence of renal
involvement
d. atherosclerosis covers a larger area of the arterial vessel as well as vessels of
smaller caliber

Question 147

The most common among diabetic neuropathies is:
a. autonomic neuropathy
b. paresis n. facialis
c. caude equine syndrome
d. entrapment syndrome n. medianus
e. distal symmetrical peripheral polyneuropathy

Answer 147

e. distal symmetrical peripheral polyneuropathy

Question 148

Mediocalcinosis
a. the measured pressures on the leg are higher than the normal value
b. causes dry tissue necrosis
c. occludes the vessel
d. usually the pressures measured in the lower extremities are lower than those in the upper
extremities
e. none of the above

Answer 148

a. the measured pressures on the leg are higher than the normal value

Question 149

Macrovascular complications:
a. are specific for diabetes
b. are more common in type 2 diabetes
c. they never develop in type 1 diabetes

Answer 149

b. are more common in type 2 diabetes

Question 150

How do we most effectively prevent complications on the legs of diabetic patients, gangrene
and amputations?
a. We examine the feet of all patients at regular intervals, regardless of whether they
report problems or not
b. We examine the feet of patients with poorly controlled diabetes
c. We examine the legs of patients who say that their legs hurt
d. We examine the legs of patients who say they have an ulcer on their leg
e. We examine the legs

Answer 150

a. We examine the feet of all patients at regular intervals, regardless of whether they
report problems or not

Question 151

Which of the following is characteristic of an ischemic ulcer?
a. Pink skin
b. Fibrin coatings and necrosis at the base of the ulcer, desquamated epithelium at the edge
c. Painless ulcer on the sole
d. Profuse, hard hyperkeratosis at the edge of the ulcer

Answer 151

b. Fibrin coatings and necrosis at the base of the ulcer, desquamated epithelium at the edge

Question 152

Diabetic foot ulcers are usually found on the surface
a. anaerobes
b. streptococci
c. staphylococci
d. enterobacteria

Answer 152

c. staphylococci

Question 153

A man after an acute myocardial infarction has a glucose level of 17 mmol/l. What do we do?
a. metformin before meals and a sulfonylurea in the evening
b. another combination with antiglycemic drugs
c. basal-prandial scheme
d. ultrashort-acting insulins before each meal
e. ultrashort insulins before each meal and at 24 hours

Answer 153

c. basal-prandial scheme

Question 154

A man has diabetes. The other day he was in the hills and had his mountain boots on all day.
He had an ulcer under his right little finger. He has no fever, but has all the features of a
neuropathic ulcer. Next to it, there is also redness, which is already on the other side of the
foot. What do we do?
a. wound toilet
b. we take an X-ray of the foot
c. laboratory (differential blood count, CRP…)
d. we prescribe an antibiotic immediately
e. we give an antibiotic only after we get an antibiogram

Answer 154

a. wound toilet
d. we prescribe an antibiotic immediately

Question 155

A 42-year-old (otherwise healthy) gentleman comes for a check-up to a selected doctor due to a
14-day-long feeling of unwellness. Describes increased thirst, frequent urination, visual and
memory disturbances, severe weakness. In the last month, he unintentionally lost weight by 6 kg.
In the laboratory results in the blood, Hb 145 g/l, leukocytes 7.0 x 109/l, platelets 250 x 109/l,
glucose 17 mmol/l , creatinine 80 micromol/l, sodium, potassium, chlorine, pH , pO2, pCO2,
bicarbonate are unremarkable. In the urineglucose +++ , proteins +,ketones +++ . The patient most
likely has:
a. SIADH
b. type 1 diabetes
c. type 2 diabetes
d. congenital glycogenosis
e. dilutional hyponatremia

Answer 155

b. type 1 diabetes

Question 156

A 35-year-old lady, who is otherwise healthy, is found to have elevated sugar (10.3 mmol/l) during
a systematic fasting examination. He does not have polyuria, polydipsia or any other health
problems. What does it have and how would you act?
a. Limit basal glycemia
b. Impaired glucose tolerance
c. On the next day, we take her blood again, the results decide whether to carry out an OGTT
d. We send her to OGTT
e. We tell the lady that she has diabetes and start therapy

Answer 156

c. On the next day, we take her blood again, the results decide whether to carry out an OGTT

Question 157

A 23-year-old patient, thirsty and polyuric for a week, has been vomiting intensely for the past 24 hours. What
is the working diagnosis upon admission to IPP?
a. Type 2 diabetes
b. Acute pancreatitis
c. Type 1 diabetes with ketoacidosis
d. Diabetes insipidus
e. Acute gastroenterocolitis

Answer 157

c. Type 1 diabetes with ketoacidosis

Question 158

A 52-year-old patient with arterial hypertension and elevated cholesterol noticed that he was very
thirsty in the last 14 days, and he also drank 5 liters of Coca-Cola a day. In addition, he passed
urine 10 times a day, at least 2 times at night. He could no longer clearly see the subtitles on the
TV, he was very tired and weak. He did not come to the chosen doctor until the afternoon, who
sent him to the laboratory, where the blood glucose level was determined to be 16.3 mmol/l. What
is the most appropriate next step for the selected physician?
a. He tells the patient that he has diabetes and starts therapy
b. He tells the patient that he probably has diabetes, but that the elevated blood
glucose should be confirmed on another fasting day.
c. He tells the patient that he probably has diabetes, but a fasting oral glucose
tolerance test must be performed to make an accurate diagnosis.
d. He tells the patient that he probably has diabetes, but to confirm definitively, he
needs to have a glucose test on another day, at which time the blood glucose
must be in the diagnostic range.
e. He tells the patient not to worry about this glucose value, as the laboratory in
question always comes with slightly elevated glucose values and is probably
unrealistic.

Answer 158

a. He tells the patient that he has diabetes and starts therapy

Question 159

A 60-year-old lady, who is otherwise perfectly healthy, measures her blood glucose value of
18.1 mmol/l on a friend’s glucometer after lunch at her granddaughter’s birthday party.
She is completely shaken by this and goes to the doctor of her choice the next day. What are
the best next steps for the chosen doctor to take?
a. The lady is referred for fasting blood glucose measurement the next day. Since the fasting blood
glucose is 9.0 mmol/l, he explains to her that she has SB and initiates treatment.
b. He refers the lady to have her fasting blood glucose measured on two different days. Once the
value is 9.0, the second time is 8.1 mmol/l. The lady explains that she probably doesn’t have SB
as her blood sugar is trending lower… and with the diet it will probably be in the normal range
soon.
c. The lady is referred for fasting blood glucose measurement the next day. Since her
fasting blood glucose is 9.0 mmol/l, he gives her a referral for an oral glucose
tolerance test to make sure with a precise method whether SB is really present.
d. He refers the lady the next day to measure fasting blood glucose and urine glucose.
Blood glucose is ? mmol/l, urine is +++. Because of the two pathological results, he
tells her that she has SB and introduces her…
e. He refers the lady to have her fasting blood glucose measured on two different days.
Once the value is 9.0, the other 8.1 mmol/l. He explains to the lady that she has SB
and starts her treatment

Answer 159

e. He refers the lady to have her fasting blood glucose measured on two different days.
Once the value is 9.0, the other 8.1 mmol/l. He explains to the lady that she has SB
and starts her treatment

Question 160

A 50-year-old patient is brought to the emergency department with a disturbance of consciousness -
soporium. Respiratory frequency 24/min, fr. heartbeat 116/min, body temperature 35.7 degrees. C.
From the laboratory findings, we understand:blood glucose 22 mmol/l , CRP 5, urea 16.5, creatinine 130,
blood pH 7.1, pO2 14.0 kPa, pCO2 4.6 kPa,anion gap 15 ,urine ketones positive.
a. exacerbation of asthma
b. acute myocardial infarction
c. diabetic ketoacidosis
d. DAHS
e. sepsis

Answer 160

c. diabetic ketoacidosis

Question 161

A patient who states that he has been very tired, thirsty and urinates frequently for several weeks,
during an outpatient examination in the laboratory, we measure KS of 13.4 mmol/l. What is the correct
action?
a. the patient is told that he has diabetes.
b. for a definitive diagnosis, it is necessary to check whether he was fasting when the blood was taken
c. another fasting glucose measurement is required for a definitive diagnosis
d. a standard tolerance test is required for a definitive diagnosis
e. for a definitive diagnosis, it is necessary to perform an ultrasound of the abdomen with an examination
of the pancreas

Answer 161

a. the patient is told that he has diabetes.

Question 162

A 55-year-old patient, who has been treated for type 2 diabetes for 8 years, had a blood
pressure of 150/90 mmHg three times in the clinic. He has no known complications of
diabetes. As a drug of first choice, we use:
a. angiotensin converting enzyme inhibitor
b. indapamide
c. beta-blocker
d. an alpha-blocker
e. calcium antagonist

Answer 162

a. angiotensin converting enzyme inhibitor

Question 163

A 42-year-old patient has a fasting blood glucose value of 4.5 mmol/l after an oral glucose
tolerance test, and 10.0 mmol/l in the 120th minute. The patient most likely has:
a. normoglycemia
b. diabetes
c. borderline basal glycemia
d. impaired glucose tolerance
e. hereditary glycogenosis

Answer 163

d. impaired glucose tolerance

Question 164

On examination, a man who has been healthy until now is short of breath, breathes quickly and deeply, his
face is red, he has a pain in the spoon, he is dehydrated, he has been going to the water a lot for a week,
during this time he has lost 8 kg, the last day he feels sick and urges to vomit, blood pressure is 120/85 mmHg.
What for example expect in his lab results?
a. glucose 5.6 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/l
b. glucose 11.1 mmol/l, ketonuria 0, arterial blood pH 7.25, potassium 4.5 mmol/l
c. glucose 22.1 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/l
d. glucose 22.1 mmol/l, ketonuria 0, arterial blood pH 7.46, potassium 4.5 mmol/l

Answer 164

c. glucose 22.1 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/l

Question 165

A previously healthy man was short of breath during the examination, breathing quickly and deeply,
reddened in the face, pain in the spoon, dehydrated, he has been going to the water a lot for a week,
during this time he lost 8 kg, the last day he felt sick and urges to vomit, blood pressure is 120/85
mmHg. Findings: glucose 22.1 mmol/l, ketonuria 3, arterial blood pH 7.25, potassium 4.5 mmol/L. You
admit him to the hospital to continue the treatment. How do you start treating it?
a. 500 ml of saline, flowing at a rate of 100 ml/h
b. 500 ml of physiological solution with the addition of 8 U of Actrapida and 20 mEq of KCl, run for
one hour, then control of glucose and potassium
c. 500 ml of 5% glucose in saline with 6 U of Actrapida, flowing at a rate of 100 ml/h
d. Actrapid 8E subcutaneously, 500 ml saline with the addition of 20 mEq KCl

Answer 165

b. 500 ml of physiological solution with the addition of 8 U of Actrapida and 20 mEq of KCl, run for
one hour, then control of glucose and potassium

Question 166

A middle-aged female patient has type 2 diabetes, for which she receives biphasic insulin twice a
day, she became ill with signs of bacterial pneumonia, which was confirmed in the emergency
internist clinic. She is hemodynamically stable, does not need supplemental oxygen, in the selfmonitoring diary of the last days, her glycemia is higher than usual, around 12.0 mmol/l in the
morning, and from 15.0 to 20.0 mmol/l during the day. What is the correct action?
a. antibiotic, hospitalization
b. antibiotic, discharge to home care, increase both doses of insulin, regular BP
measurements and self-titration of insulin dose, follow-up with general
practitioner/family doctor according to pneumonia and glycemic status
c. antibiotic, discharge to home care without additional measures
d. antibiotic, discharge to home care, check-up with a diabetologist in 1 month

Answer 166

b. antibiotic, discharge to home care, increase both doses of insulin, regular BP
measurements and self-titration of insulin dose, follow-up with general
practitioner/family doctor according to pneumonia and glycemic status

Question 167

A patient is receiving metformin and an insulin secretagogue, both in the maximum permitted
dose. He takes medicine regularly. This morning he took them as usual, ate a small breakfast, then
skipped lunch due to a dentist appointment. At the dentist, he became confused and sweaty
already in the waiting room. His blood glucose was measured. What result do you expect and what
is the measure?
a. glucose 2.5 mmol/l, it is hypoglycemia, the patient receives an IV infusion of 20-50%
glucose until the normalization of consciousness or glycemia over 10 mmol/l,
hospitalization will be necessary
b. glucose 15.6 mmol/l, the patient should go home, insulin treatment will be
required
c. glucose 5.6 mmol/l, the patient is afraid, he can go home
d. glucose 2.5 mmol/l, it is hypoglycemia, the patient drinks 2 dl of tea with three
tablespoons of dissolved sugar, the patient can go home, buy a meter and measure
his blood sugar for the next week before each meal

Answer 167

a. glucose 2.5 mmol/l, it is hypoglycemia, the patient receives an IV infusion of 20-50%
glucose until the normalization of consciousness or glycemia over 10 mmol/l,
hospitalization will be necessary

Question 168

A 68-year-old patient with long-term poorly controlled type 2 diabetes comes to the outpatient clinic
because of a fresh ulcer on the sole of the foot, under the ball of the third foot, which appeared after
walking around the mall all Saturday. He has an elevated temperature of 37.8 °C. The wound is
surrounded by a hyperkeratotic border, a small amount of serous discharge is oozing from the wound,
the surrounding area is red, and even the foot is warm to the touch. The wound doesn’t hurt him.
Diagnosis: It is an ischemic ulcer.
a. True
b. It’s not true

Answer 168

b. It’s not true

Question 169

A 23-year-old patient was brought to the IPP because of persistent vomiting lasting 24 hours,
before which he had noticed increased thirst, polyuria and general fatigue for about a week.
What is the most likely working diagnosis?
a. acute gastroenterocolitis
b. acute pancreatitis
c. newly diagnosed type 2 diabetes
d. newly diagnosed type 1 diabetes with ketoacidosis

Answer 169

d. newly diagnosed type 1 diabetes with ketoacidosis

Question 170

An 80-year-old DSO patient is brought to the IPP with poor contactability, clinically
dehydrated, RR 110/65 mm Hg. Findings: glucose 45 mMol/L, urea 35, creatinine 275. How
would you start the treatment?
a. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 8 U/h
b. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 24 U/h
c. infusion of 0.9% NaCl solution 500 ml/4h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 8 U/h
d. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid, Humulin
R) 8 U sc, after one hour KS control and dose modification if necessary

Answer 170

a. infusion of 0.9% NaCl solution 1000 ml/h, short-acting insulin (Actrapid,
Humulin R) via perfusor, in an initial dose of 8 U/h

Question 171

. A 48-year-old woman, so far healthy and without regular drug therapy, is referred to
the triage diabetes clinic because a systematic examination at work revealed a fasting
blood sugar level of 10.3 mmol/L. At the same time, she did not feel increased thirst, was
not polyuric and did not lose weight. She smokes 10 cigarettes a day, does sedentary
work (administrator), does not play sports. On examination TV 163 cm, TT 80 kg, RR
149/95 mmHg, KS fasting 9.8 mmol/L, HbA1c 8.5%. How would you act?
a. we advise a healthy diet, regular physical activity and weight reduction and
introduce metformin
b. we advise a healthy diet, regular physical activity and weight reduction
c. the patient is referred for an OGTT, until then no therapeutic measures are
introduced
d. a sulfonylurea is introduced
e. we introduce metformin

Answer 171

b. we advise a healthy diet, regular physical activity and weight reduction

Question 172

An 8-year-old patient with long-term poorly controlled type 2 diabetes comes to the clinic because of a
fresh ulcer on the sole of the foot, under the ball of the third foot, which appeared after walking around
the mall all Saturday. He has an elevated temperature of 37.8 °C. The wound is surrounded by a
hyperkeratotic border, a small amount of serous discharge is oozing from the wound, the surrounding
area is red, and even the foot is warm to the touch. The wound doesn’t hurt him. What is it about?
a. ischemic ulcer
b. neuroischemic ulcer
c. neuropathic ulcer

Answer 172

c. neuropathic ulcer

Question 173

A 48-year-old woman, so far healthy and without regular drug therapy, is referred to the
triage diabetes clinic because a systematic examination at work revealed a fasting blood
sugar level of 10.3 mmol/L. At the same time, she did not feel increased thirst, was not
polyuric and did not lose weight. She smokes 10 cigarettes a day, does sedentary work
(administrator), does not play sports. On examination TV 163 cm, TT 80 kg, RR 149/95 mmHg,
KS fasting 9.8 mmol/L, HbA1c 8.5%. In the diagnostic procedure, all investigations are
meaningful,except:
a. preventive foot examination
b. lipidogram
c. urea, creatinine, oGF, native urine
d. examination of the fundus of the eye
e. hemogram

Answer 173

e. hemogram

Question 174

A 48-year-old woman, so far healthy and without regular drug therapy, is referred to the
triage diabetes clinic because a systematic examination at work revealed a fasting blood
sugar level of 10.3 mmol/L. At the same time, she did not feel increased thirst, was not
polyuric and did not lose weight. She smokes 10 cigarettes a day, does sedentary work
(administrator), does not play sports. On examination TV 163 cm, TT 80 kg, RR 149/95 mmHg,
KS fasting 9.8 mmol/L, HbA1c 8.5%. What is it about?
a. The patient has newly diagnosed type 2 diabetes
b. The patient has borderline basal glycemia
c. The patient probably has type 2 diabetes, but we need to do an OGTT
response to confirm

Answer 174

a. The patient has newly diagnosed type 2 diabetes

Question 175

During the screening test, the patient says that he has to stop after about 100 m when
walking on a flat surface because of pain in his legs, which subsides after a short rest, and he
cannot walk uphill at all. He likes to get cold in his legs, and every little wound or injury is
extremely reluctant to heal. Type 2 diabetes is 20 years old, takes insulin, HbA1c 7.2%.
During the examination, we find a loss of protective sensitivity at 1 point on the right and at 2
points on the left foot. Foot pulses are not palpable. There are no deformations. He smokes up to
5 cigarettes a day, receives medication for high blood pressure and cholesterol. TV 181 cm, TT 80
kg. What is it about and how to act?
a. The patient has a circulatory disorder and sensory neuropathy, needs an
angiologist examination, smoking cessation, custom shoes and pain
medication
b. The patient has sensory neuropathy, he needs painkillers due to the feeling of cold
feet. He should not remove hard skin and nails himself, but should go to a pedicurist.
If his legs get cold at night, he should help himself with a hot water bottle or a
heating pad
c. The patient has a disorder of arterial circulation, it is necessary to quit smoking and be
examined by an angiologist. It is necessary to wear comfortable, soft and warm footwear
and to avoid injuries, regular self-examination of the feet
d. The patient has a disorder of arterial circulation and is at risk of developing an ulcer.
Regular foot self-examination and custom-made shoes are essential

Answer 175

c. The patient has a disorder of arterial circulation, it is necessary to quit smoking and be
examined by an angiologist. It is necessary to wear comfortable, soft and warm footwear
and to avoid injuries, regular self-examination of the feet

Question 176

During a preventive examination of the legs, the patient says that he has painful spasms in the legs,
especially at night, and can walk long distances without problems. Upon examination, we find a loss of
protective sensitivity at 7 points on the right and at 9 points on the left foot, as well as an unreliable
sense of heat and cold. Foot pulses are palpable. There are no deformations. Diabetes is managed with
tablets, HbA1c is 8.0%. He regularly smokes 10-15 cigarettes a day, does not have elevated blood fats,
and his blood pressure is well controlled with a combination of two medications. TV 170 cm, TT 90 kg.
What is it about and how would you act?
a. The patient has a circulatory disorder and sensory neuropathy, needs an
angiologist examination, smoking cessation, custom shoes, pain medication, and
immediate initiation of insulin therapy
b. The patient has a disorder of arterial circulation, it is necessary to stop smoking and be examined by an
angiologist
c. The patient has sensory neuropathy and is at risk of ulceration. Regular selfexamination of the feet, smoking cessation, weight loss, strict adherence to
the principles of a healthy diet and the introduction of insulin are essential
if lifestyle changes are not sufficient.
d. The patient has sensory neuropathy and is at risk of ulceration. Regular foot selfexamination and custom-made shoes are essential

Answer 176

c. The patient has sensory neuropathy and is at risk of ulceration. Regular selfexamination of the feet, smoking cessation, weight loss, strict adherence to
the principles of a healthy diet and the introduction of insulin are essential
if lifestyle changes are not sufficient.

Question 177

A 77-year-old patient with long-standing type 2 diabetes, arterial hypertension, hypercholesterolemia,
and ischemic heart disease has been being monitored in the outpatient clinic for six months due to an
ulcer under the ball of the 3rd foot on the right foot, which occurred after a day trip during which he
walked more than usual. The leg is warm, the skin is pink, the ulcer is surrounded by an abundant
hyperkeratotic rim, there is little secretion, the bottom is clean, there is no redness or swelling in the
area. The area of the ulcer does not decrease. What is it about and how would you act?
a. The patient has a neuropathic ulcer. The cause of poor healing is most likely
insufficient relief of the affected area - the patient needs a temporary shoe
or plaster slipper
b. The patient has a neuroischemic ulcer, the cause of poor healing is most likely an
infection, an antibiotic is needed
c. The patient has a neuropathic ulcer. Because healing is poor, an underlying
circulatory disorder is most likely overlooked
d. The patient undoubtedly has an ischemic ulcer, he urgently and immediately needs an examination by an
angiologist

Answer 177

a. The patient has a neuropathic ulcer. The cause of poor healing is most likely
insufficient relief of the affected area - the patient needs a temporary shoe
or plaster slipper

Question 178

Data from the anamnesis and changes in the legs, which are evaluated during the
preventive examination - screening test, are listed. Which of the above is sufficient in
itself to place the patient in the most endangered category - risk group 4?
a. Loss of sensation to touch (with monofilament) and to vibration
b. He had a leg ulcer in the past
c. Absent foot pulses
d. Leg deformities – hallux valgus, clawed toes

Answer 178

b. He had a leg ulcer in the past

Question 179

A 65-year-old retired auto mechanic was diagnosed with rectosigmoid cancer with metastases in the
regional lymph nodes and liver. He underwent surgery, has a stoma, started chemotherapy, after which
he vomits several times, his appetite is poor, he lost 10 kg. During treatment, newly discovered diabetes,
HbA1c 8.5%, initially treated in the hospital with a basal-bolus scheme, with glycemia in the daily profile
between 8 and 10 mmol/L. What kind of therapeutic scheme would you try to implement at home?
a. Humalog with main meals and Humulin N at bedtime
b. Humalog mix (25) morning and evening
c. Diaprel MR and Aglurab
d. only Diaprel MR

Answer 179

a. Humalog with main meals and Humulin N at bedtime

Question 180

A 70-year-old female patient, who has been treated for diabetes for 15 years, for the last 6 months
with a combination of oral antidiabetics and long-acting insulin at bedtime, a long-term smoker,
comes to the clinic because of an ulcer on the lateral edge of the left heel. She attributes the
problem to the new shoes she bought a week ago and then walked around the mall in them all
afternoon. On examination, the leg is cold, the skin is thin and bluish in color, we can see a
detached epidermis on the edge of the heel, there is almost no hyperkeratosis, necrosis is visible
at the bottom of the ulcer. Foot pulses absent. There are no local or systemic signs of infection.
What is it about and how would you act?
a. The patient got a blister from new, unworn shoes, she has to stretch it on the
hoof, she should wear her old shoes for a few days, the ulcer will heal by
itself
b. The patient has a disorder of arterial circulation and necrosis at the base of the callus,
which was caused by inappropriate footwear. He needs rest and relief and an immediate
examination by an angiologist
c. The patient has sensory neuropathy, which is why she developed a blister. In order to prevent
infection, he needs an antibiotic and once a day bandage the wound with sterile gauze
d. The patient has a disorder of arterial circulation and necrosis at the base of the callus, which was
caused by inappropriate footwear. Since she has no signs of infection, we advise her to cover
the blister with sterile gauze, rest for a few days and check with her doctor if there is no
improvement within a week

Answer 180

b. The patient has a disorder of arterial circulation and necrosis at the base of the callus,
which was caused by inappropriate footwear. He needs rest and relief and an immediate
examination by an angiologist

Question 181

Nesidioblastosis is:
a. functional excess insulin secretion after a carbohydrate-rich meal
b. pancreatic beta cell hyperplasia
c. hypoglycemia induced by increased secretion of IGF-1 and IGF-2
d. a subtype of alimentary hypoglycemia
e. hypoglycemic syndrome caused by pituitary failure

Answer 181

b. pancreatic beta cell hyperplasia

Question 182

Insulin counterregulatory hormones are:
a. glucagon
b. growth hormone
c. cortisol
d. adrenaline

Answer 182

All of them

Question 183

The following applies to diabetes:
a. antihypertensive therapy is not so important in diabetics, as it is more
important to correct blood sugar
b. if hypoglycemia occurs, we do not adjust the medication doses, as it is important to
reach the target pressure
c. diabetics more often have orthostatic hypotension, which manifests itself as higher blood pressure when sitting than when lying
down

Question 184

Hypoglycemia with sulfonylurea:
a. As a rule, it requires hospitalization.
b. The most dangerous are preparations with a short-term but intense effect
c. They are common in kidney failure
d. In case of diarrhea or vomiting or fasting, sulfonylureas should not be
taken for fear of hypoglycemia

Answer 184

A,C,D

Question 185

What is the definition of chronic kidney disease?
a. Glomerular filtration rate < 60 mL/min OR signs of renal impairment present
for at least 3 months

Answer 185

a. Glomerular filtration rate < 60 mL/min OR signs of renal impairment present
for at least 3 months

Question 186

How many antihypertensive drugs are needed on average to control blood pressure at
a diabetic?
a. 1
b. 2
c. 3

Answer 186

c. 3

Question 187

With idiopathic reactive hypoglycemia, we get:
a. Most often it appears on an empty stomach
b. It most often occurs 5 hours after a mixed meal
c. It is the result of functionally excessive secretion of insulin
d. It is mostly adrenergic stimulation after a meal
e. It is more common in obese people
f. It is more common in emotionally unstable women

Answer 187

f. It is more common in emotionally unstable women

Question 188

To neuroglycopenic signs of hypoglycemia we don’t add:
a. sweating
b. cramps
c. cognitive disorders
d. loss of consciousness
e. unusual behavior

Answer 188

a. sweating

Question 189

The most common cause of hypoglycemia is:
a. alcoholism
b. insulinoma
c. exogenous hyperinsulinism
d. autoimmune event
e. advanced chronic renal failure

Answer 189

c. exogenous hyperinsulinism

Question 190

What doesn’t apply to alcohol hypoglycemia:
a. It is a common cause of hypoglycemia
b. It is the result of poor nutrition, alcohol and liver damage
c. Chronic liver damage is not a condition for alcoholic hypoglycemia
d. We treat her with glucagon. or concentrated glucose iv.
e. Severe hypoglycemia is not related to the amount of alcohol consumed

Answer 190

d. We treat her with glucagon. or concentrated glucose iv.

Question 191

Hypoglycemia:
a. it is characterized by a diverse set of causes but a specific set of symptoms
b. it is mostly easily recognizable
c. it most often occurs in emotionally labile women
d. occurs in predominantly dry patients
e. is a characteristic symptom of many congenital metabolic disorders

Answer 191

e. is a characteristic symptom of many congenital metabolic disorders

Question 192

Acute gastroenterocolitis increases the likelihood of:
a. hyperglycemia
b. hypoglycemia

Answer 192

b. hypoglycemia

Question 193

Which of the following doesn’t belong to the adrenergic symptoms of hypoglycemia?
a. Tachycardia
b. Confusion
c. Sweating
d. Pallor
e. Paresthesias around the mouth
f.Epileptiform convulsions
g. Trembling

Answer 193

b. Confusion
e. Paresthesias around the mouth
f.Epileptiform convulsions

Question 194

The patient underwent a fasting test due to spontaneous hypoglycemia, which was interrupted
after 18 hours due to hypoglycemia with a blood glucose concentration of 2.4 mmol/l. At the same
time, a decreased concentration of C-peptide, an increased concentration of insulin, and no
sulfonylurea metabolites were detected in the urine. Most likely to go?
a. prediabetes
b. application of exogenous insulin
c. late postprandial hypoglycemia
d. incorrect dose of sulfonylureas
e. insulinoma

Answer 194

b. application of exogenous insulin

Question 195

Circle the correct statements.
a.The difference between hypoglycemic coma and diabetic ketoacidosis (DKA) is that
hypoglycemic coma has an abrupt onset, while DKA has a slower onset..
b. In hypoglycemic coma and DKA, the heart action is tachycardic.
c. Kussmaul respiration is present in hypoglycemic coma and DKA.

Answer 195

A and B

Question 196

Alcoholic hypoglycemia:
a. the degree of hypoglycemia is proportional to the amount of alcohol consumed
b. hypoglycemia often occurs only when the signs of intoxication subside
c. chronic liver failure is a condition for alcoholic hypoglycemia
d. we must objectively rule out hypoglycemia in every drunk person with
impaired consciousness
e. hypoglycemia is treated with glucose and glucagon

Answer 196

B and D

Question 197

Hypoglycemia causes are not:
a. Acute liver failure
b. Acute renal failure
c. Acute myocardial infarction
d. Panhypopituitarism
e. Alcohol

Answer 197

c. Acute myocardial infarction

Question 198

In type 1 diabetes, the serum concentration is increased
a. triglycerides
b. chylomicrons
c. HDL
d. LDL

Answer 198

a. triglycerides
b. chylomicrons
d. LDL

Question 199

Which of the listed oral antidiabetics belong to insulin secretagogues?
a. metformin
b. SGLT-2 inhibitors
c. sulfonylureas
d. meglitinides (glinides)
e. DPP-4 inhibitors
f. acarbose

Answer 199

c. sulfonylureas
d. meglitinides (glinides)

Question 200

STH inhibits the action of insulin on cells and increases insulin resistance
a. True
b. It’s not true

Answer 200

a. True