Clinical Management Test 2
What is the primary pathophysiological defect in Type 1 diabetes?
A. Insulin resistance
B. Insulin deficiency due to pancreatic beta-cell destruction
C. Increased hepatic glucose production
D. Reduced renal glucose excretion - ANS: B. Insulin deficiency due to pancreatic beta-cell destruction
How does the incretin effect contribute to the management of Type 2 diabetes?
A. Increases insulin sensitivity in muscles
B. Enhances insulin secretion in response to meals
C. Reduces renal glucose reabsorption
D. Lowers hepatic glucose production - ANS: B. Enhances insulin secretion in response to meals
What autoimmune processes are involved in the pathogenesis of Type 1 diabetes? - ANS: Type 1
diabetes is caused by an autoimmune attack on pancreatic beta cells, leading to insulin deficiency. This
autoimmune response often involves antibodies against islet cells and insulin
What are the diagnostic criteria for diabetes based on fasting plasma glucose (FPG)?
A. FPG ≥ 126 mg/dL
B. FPG ≥ 100 mg/dL
C. FPG ≥ 200 mg/dL
D. FPG ≥ 140 mg/dL - ANS: A. FPG ≥ 126 mg/dL
Which of the following is NOT a risk factor for Type 2 diabetes?
A. Family history of diabetes
,B. Sedentary lifestyle
C. Caucasian race
D. History of gestational diabetes - ANS: C. Caucasian race
Why are the rates of Type 2 diabetes increasing worldwide? - ANS: Increasing rates of obesity, sedentary
lifestyles, and aging populations are contributing to the rising prevalence of Type 2 diabetes globally
What percentage of women with gestational diabetes develop Type 2 diabetes postpartum?
A. 5-10%
B. 15-25%
C. 30-50%
D. 50-70% - ANS: A. 5-10%
Which of the following conditions is a criterion for early prenatal diabetes testing?
A. A history of delivering a baby weighing more than 9 lbs
B. A first-degree relative with Type 1 diabetes
C. Sedentary lifestyle
D. Hypertension ≥ 140/90 mmHg - ANS: A, C, and D
At what age should screening for Type 2 diabetes in asymptomatic adults begin?
A. 25 years
B. 35 years
C. 45 years
D. 55 years - ANS: C. 45 years
What is the first line of pharmacologic therapy for diabetes with nephropathy?
,A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Statins - ANS: A. ACE inhibitors
Which diabetes-related complication involves a loss of protective sensation in the feet?
A. Diabetic retinopathy
B. Diabetic nephropathy
C. Diabetic neuropathy
D. Macrovascular disease - ANS: C. Diabetic neuropathy
What are the goals for blood pressure control in patients with diabetes?
A. 120/80 mmHg
B. 130/90 mmHg
C. 140/90 mmHg
D. 150/100 mmHg - ANS: B. 130/90 mmHg
Which lifestyle modification is recommended to prevent or delay the onset of Type 2 diabetes? - ANS:
Achieve and maintain 7% weight loss and engage in at least 150 minutes per week of moderate-intensity
physical activity
Which 2 oral antihyperglycemic agent is contraindicated during pregnancy?
A. Metformin
B. Glyburide
C. Sitagliptin
D. Pioglitazone - ANS: C. Sitagliptin
, D. Pioglitazone
What is the recommended pharmacologic therapy for glycemic control during pregnancy? - ANS: Insulin
is the preferred treatment for hyperglycemia in pregnancy
What effect does obesity have on insulin dosing during pregnancy?
A. No effect
B. Decreases the need for insulin
C. Increases the insulin dose requirement
D. Increases the risk of hypoglycemia - ANS: C. Increases the insulin dose requirement
A 65-year-old man with Type 2 diabetes presents with worsening kidney function. What is the next best
step in his management? - ANS: Start an ACE inhibitor or ARB to slow the progression of diabetic
nephropathy
A 28-year-old woman with gestational diabetes is concerned about her risk for developing Type 2
diabetes postpartum. What advice should be given? - ANS: Women with gestational diabetes have a 35-
60% risk of developing Type 2 diabetes over the next 10-20 years; regular screening and lifestyle
interventions are recommended
A 50-year-old patient with Type 1 diabetes is experiencing frequent hypoglycemia. What adjustments
should be made? - ANS: Adjust insulin therapy by lowering basal insulin doses and increasing
carbohydrate intake before meals
What are the goals of therapy for a 70-year-old patient with Type 2 diabetes and cardiovascular disease?
- ANS: The goals should focus on individualized A1C control (below 8%) and aggressive cardiovascular risk
factor management, including blood pressure and lipid control
Which complication is more common in Type 1 diabetes compared to Type 2 diabetes?
What is the primary pathophysiological defect in Type 1 diabetes?
A. Insulin resistance
B. Insulin deficiency due to pancreatic beta-cell destruction
C. Increased hepatic glucose production
D. Reduced renal glucose excretion - ANS: B. Insulin deficiency due to pancreatic beta-cell destruction
How does the incretin effect contribute to the management of Type 2 diabetes?
A. Increases insulin sensitivity in muscles
B. Enhances insulin secretion in response to meals
C. Reduces renal glucose reabsorption
D. Lowers hepatic glucose production - ANS: B. Enhances insulin secretion in response to meals
What autoimmune processes are involved in the pathogenesis of Type 1 diabetes? - ANS: Type 1
diabetes is caused by an autoimmune attack on pancreatic beta cells, leading to insulin deficiency. This
autoimmune response often involves antibodies against islet cells and insulin
What are the diagnostic criteria for diabetes based on fasting plasma glucose (FPG)?
A. FPG ≥ 126 mg/dL
B. FPG ≥ 100 mg/dL
C. FPG ≥ 200 mg/dL
D. FPG ≥ 140 mg/dL - ANS: A. FPG ≥ 126 mg/dL
Which of the following is NOT a risk factor for Type 2 diabetes?
A. Family history of diabetes
,B. Sedentary lifestyle
C. Caucasian race
D. History of gestational diabetes - ANS: C. Caucasian race
Why are the rates of Type 2 diabetes increasing worldwide? - ANS: Increasing rates of obesity, sedentary
lifestyles, and aging populations are contributing to the rising prevalence of Type 2 diabetes globally
What percentage of women with gestational diabetes develop Type 2 diabetes postpartum?
A. 5-10%
B. 15-25%
C. 30-50%
D. 50-70% - ANS: A. 5-10%
Which of the following conditions is a criterion for early prenatal diabetes testing?
A. A history of delivering a baby weighing more than 9 lbs
B. A first-degree relative with Type 1 diabetes
C. Sedentary lifestyle
D. Hypertension ≥ 140/90 mmHg - ANS: A, C, and D
At what age should screening for Type 2 diabetes in asymptomatic adults begin?
A. 25 years
B. 35 years
C. 45 years
D. 55 years - ANS: C. 45 years
What is the first line of pharmacologic therapy for diabetes with nephropathy?
,A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Statins - ANS: A. ACE inhibitors
Which diabetes-related complication involves a loss of protective sensation in the feet?
A. Diabetic retinopathy
B. Diabetic nephropathy
C. Diabetic neuropathy
D. Macrovascular disease - ANS: C. Diabetic neuropathy
What are the goals for blood pressure control in patients with diabetes?
A. 120/80 mmHg
B. 130/90 mmHg
C. 140/90 mmHg
D. 150/100 mmHg - ANS: B. 130/90 mmHg
Which lifestyle modification is recommended to prevent or delay the onset of Type 2 diabetes? - ANS:
Achieve and maintain 7% weight loss and engage in at least 150 minutes per week of moderate-intensity
physical activity
Which 2 oral antihyperglycemic agent is contraindicated during pregnancy?
A. Metformin
B. Glyburide
C. Sitagliptin
D. Pioglitazone - ANS: C. Sitagliptin
, D. Pioglitazone
What is the recommended pharmacologic therapy for glycemic control during pregnancy? - ANS: Insulin
is the preferred treatment for hyperglycemia in pregnancy
What effect does obesity have on insulin dosing during pregnancy?
A. No effect
B. Decreases the need for insulin
C. Increases the insulin dose requirement
D. Increases the risk of hypoglycemia - ANS: C. Increases the insulin dose requirement
A 65-year-old man with Type 2 diabetes presents with worsening kidney function. What is the next best
step in his management? - ANS: Start an ACE inhibitor or ARB to slow the progression of diabetic
nephropathy
A 28-year-old woman with gestational diabetes is concerned about her risk for developing Type 2
diabetes postpartum. What advice should be given? - ANS: Women with gestational diabetes have a 35-
60% risk of developing Type 2 diabetes over the next 10-20 years; regular screening and lifestyle
interventions are recommended
A 50-year-old patient with Type 1 diabetes is experiencing frequent hypoglycemia. What adjustments
should be made? - ANS: Adjust insulin therapy by lowering basal insulin doses and increasing
carbohydrate intake before meals
What are the goals of therapy for a 70-year-old patient with Type 2 diabetes and cardiovascular disease?
- ANS: The goals should focus on individualized A1C control (below 8%) and aggressive cardiovascular risk
factor management, including blood pressure and lipid control
Which complication is more common in Type 1 diabetes compared to Type 2 diabetes?
