Ophthalmology: Diabetes Mellitus

Question 0

diabetes

Answer 0

the leading cause of new blindness in adults ages 20 to 74

Question 1

8%

Answer 1

prevalence of diabetes

Question 2

4

Answer 2

calculate relative risk of diabetes at 40% above ideal body weight

Question 3

32

Answer 3

calculate relative risk of diabetes at 100% above ideal body weight

Question 4

25%

Answer 4

percentage of new cases of T1DM after age 35

Question 5

latent autoimmune diabetes in adults

Answer 5

term for 10% of type 2 diabetics found to have islet cell autoantibodies and tend to require insulin therapy

Question 6

44%

Answer 6

incidence of metabolic syndrome in adults over 50

Question 7

false

Answer 7

TRUE or FALSE: NPDR does not occur in pre diabetics

Question 8

restrictive, malabsorptive

Answer 8

two general types of bariatric surgery

Question 9

dawn phenomenon

Answer 9

morning hyperglycemia triggered by growth hormone

Question 10

Somogyi phenomenon

Answer 10

morning hyperglycemia triggered by hypoglycemia overnight (uncommon)

Question 11

true

Answer 11

True or False: most patients who initially respond to sulfonylureas will fail to achieve control within a few years

Question 12

DCCT

Answer 12

demonstrated the efficacy of intensive insulin therapy (injections or pump) in preventing microvascular complications in T1DM

Question 13

UKPDS

Answer 13

study that showed the importance of keeping HA1C under 7 to prevent microvascular complications

Question 14

8

Answer 14

over this HA1C the risk of retinopathy (in the DCCT) really takes off

Question 15

7-8

Answer 15

based on the ACCORD trial, that demonstrated a cardiovascular risk to intensive control (inT2DM ONLY!!), the A1C may be ideally kept in this range

Question 16

quarterly

Answer 16

A1C should be measured at this interval in diabetics with poor control

Question 17

sorbitol buildup, protein kinase C activation, glycosylation

Answer 17

three pathophysiologic mechanisms by which hyperglycemia causes disease

Question 18

20%

Answer 18

5-year survival of diabetics on maintenance dialysis (under…)

Question 19

IGFBPs

Answer 19

vitreal proteins that are elevated in diabetic patients without retinopathy and may play an early role in the pathogenesis

Question 20

true

Answer 20

TRUE or FALSE: Type 2 diabetics do NOT develop the snowflake cataract

Question 21

sorbitol

Answer 21

The role of accumulation of this glucose byproduct in causing cataracts in diabetes is controversial (animal models support but seems less likely in humans)

Question 22

mitochondrial

Answer 22

adult-onset diabetes and deafness are associated with this inheritance pattern

Question 23

epithelial basement membrane thickening, decreased anchoring fibrils, decreased hemidesmosomes

Answer 23

these three ultrastructural corneal changes are associated with poor wound healing in diabetics

Question 24

lacy vacuolization

Answer 24

iris pigment epithelium change in diabetes

Question 25

impaired autoregulation, blood flow alterations, breakdown of the blood-retina barrier

Answer 25

three physiologic retinal vascular changes in diabetes

Question 26

basement membrane thickening, microaneurysms, pericyte loss, retinal capillary closure

Answer 26

four microcirculation changes in diabetic retinopathy

Question 27

outer retina

Answer 27

primary tissue destroyed in argon laser photocoagulation

Question 28

AION

Answer 28

diabetic papillopathy may represent one end of the spectrum of this disease

Question 29

FA

Answer 29

test to distinguish between diabetic papillopathy and NVD

Question 30

head CT

Answer 30

should be ordered in a patient with suspicion for bilateral diabetic papillopathy

Question 31

10 years

Answer 31

no child should have a screening exam for diabetic retinopathy under this age

Question 32

3 years

Answer 32

minimum duration of diabetes before a screening exam in a child

Question 33

true

Answer 33

TRUE or FALSE: PDR is prohibitively rare in the pediatric population

Question 34

prolonged hypoglycemia

Answer 34

presumed mechanism of hypesthesia in diabetes

Question 35

true

Answer 35

TRUE or FALSE: most studies, including the OHTS, do not find a link between diabetes and OAG

Question 36

myopic shift, early presbyopia

Answer 36

lenticular manifestations of diabetes other than cataracts

Question 37

early

Answer 37

at what time of day should surgery on diabetics be performed

Question 38

NSAIDS

Answer 38

preoperative topical medication that has shown to reduce incidence of CME in diabetics