KSA Diabetes Exam: Questions & Answers: | Updated
/. 1. A 35-year-old male sees you for a routine health maintenance visit. He has gained
a few pounds over the past few years. He is 173 cm (68 in) tall and weighs 82 kg (181
lb), giving him a BMI of 27 kg/m2.According to current American Diabetes Association
guidelines, which one of the following additional factors would warrant screening him for
prediabetes and diabetes? - Answer-E. Physical inactivity
/.2. An obese 58-year-old male comes to your office with a 2-week history of fatigue
associated with polyuria, polydipsia, and weight loss. You suspect he has type 2
diabetes. This diagnosis would be corroborated by a random glucose level greater than
or equal to a threshold of - Answer-D. 200 mg/dL
/.3. A 66-year-old male who was hospitalized because of a TIA 3 months ago sees you
for a follow-up visit. His past medical history is notable for impaired fasting glucose and
hypertension. His current medications include valsartan (Diovan), 160 mg daily;
rosuvastatin (Crestor), 20 mg daily; and aspirin, 81 mg daily. On examination his BMI is
30 kg/m2, his blood pressure is 134/86 mm Hg, and he has brown, velvety,
hyperkeratotic plaques on the back of his neck and in his axillae. Laboratory studies are
notable for an LDL-cholesterol level of 85 mg/dL, an HDL-cholesterol level of 35 mg/dL,
and a serum triglyceride level of 174 mg/dL. His hemoglobin A1c is 7.1%.
Which one of the following agents may reduce his risk for stroke and myocardial
infarction? - Answer-D. Pioglitazone (Actos)
/.4. A 71-year-old male is hospitalized for an infected foot ulcer. His medical history is
notable for type 2 diabetes, hypertension, and chronic pancreatitis. His medications on
admission include pancrelipase (Creon), 72,000 units with each meal; extended-release
metformin (Glucophage XR), 500 mg four times daily; extended-release glipizide
(Glucotrol XL), 5 mg daily; and benazepril (Lotensin), 40 mg daily. Insulin therapy is
initiated for hyperglycemia with persistent blood glucose levels ≥200 mg/dL.
Based on American Diabetes Association guidelines, which one of the following would
be the most appropriate glycemic target for this patient during his hospitalization? -
Answer-C. 140-180 mg/dL
/.5. An obese 53-year-old male with a history of type 2 diabetes sees you for the first
time. He tells you that his previous physician had him see a dietician and started him on
metformin (Glucophage), 500 mg twice daily. A copy of his most recent laboratory tests
shows a hemoglobin A1c of 7.7%. He tells you that he has always been sedentary and
asks if it would be worthwhile for him to join an exercise facility and begin an exercise
program.
Which one of the following statements would be accurate advice? - Answer-C.
Combined aerobic and resistance training results in greater glycemic improvement than
either method alone
, /.6. An overweight, sedentary 71-year-old male presents with a 4-month history of
burning pain in the soles of his feet that is most noticeable at night when he is lying in
bed. His medical history includes a long history of type 2 diabetes, hypertension, and
hypercholesterolemia. His current medications include metformin (Glucophage), 850 mg
twice daily; exenatide (Bydureon), 2 mg subcutaneously weekly; valsartan (Diovan), 360
mg daily; hydrochlorothiazide, 25 mg daily; and rosuvastatin (Crestor), 10 mg daily. He
quit smoking 40 years ago and does not drink alcohol. A physical examination is
unremarkable except for some hyperesthesia of both feet, as well as reduced vibratory
sensation. His protective sensation is intact in both feet and his pedal pulses are
normal.
Which one of the following would be LEAST effective for treating this patient's pain
syndrome? - Answer-B. SSRIs
/.7. A 71-year-old male presents early on a Saturday morning to the urgent care clinic
you are staffing. He describes a 1-week history of episodic sweating, feelings of hunger,
and tremor that are relieved by eating. He reports that he has type 2 diabetes and has
taken metformin (Glucophage) for years, and that his physician recently added a new
diabetes medication because his hemoglobin A1c rose above 7.5%. He did not bring his
medications with him and you are unable to access his records because the electronic
medical record system is undergoing routine maintenance and an update.
Which one of the following diabetes medications would be most likely to cause this
patient's symptoms? - Answer-C. Glyburide
/.8. A 55-year-old male with type 2 diabetes presents with a history of reduced libido
and erectile dysfunction. He has not seen a physician for many years. On examination
you note bronze-colored skin, hepatomegaly, and mild testicular atrophy. A nonfasting
laboratory workup reveals the following serum levels:
Glucose............250 mg/dL
AST............260 U/L (N 10-40)
ALT............210 U/L (N 10-55)
FSH............5.0 mIU/mL (N 1.0-12.0)
LH............8.1 mIU/mL (N 2.0-12.0)
Testosterone............180 ng/mL (N 280-1250)
Which one of the following is the most likely diagnosis? - Answer-D. Hemachromatosis
/.9. A 67-year-old male sees you 6 months after he was hospitalized with a non-ST-
elevation myocardial infarction. He also has a history of hypertension and type 2
diabetes. His current medications are rosuvastatin (Crestor), 40 mg daily; benazepril
(Lotensin), 20 mg daily; metoprolol, 25 mg twice daily; aspirin, 81 mg daily; and
clopidogrel (Plavix), 75 mg daily. His fasting lipid profile reveals a total cholesterol level
of 198 mg/dL, an LDL-cholesterol level of 70 mg/dL, an HDL-cholesterol level of 40
mg/dL, and a serum triglyceride level of 375 mg/dL.
Adding which one of the following agents is recommended by the American Diabetes
Association to further reduce his cardiovascular risk? - Answer-E. Icosapent ethyl
(Vascepa), 4 g daily
/. 1. A 35-year-old male sees you for a routine health maintenance visit. He has gained
a few pounds over the past few years. He is 173 cm (68 in) tall and weighs 82 kg (181
lb), giving him a BMI of 27 kg/m2.According to current American Diabetes Association
guidelines, which one of the following additional factors would warrant screening him for
prediabetes and diabetes? - Answer-E. Physical inactivity
/.2. An obese 58-year-old male comes to your office with a 2-week history of fatigue
associated with polyuria, polydipsia, and weight loss. You suspect he has type 2
diabetes. This diagnosis would be corroborated by a random glucose level greater than
or equal to a threshold of - Answer-D. 200 mg/dL
/.3. A 66-year-old male who was hospitalized because of a TIA 3 months ago sees you
for a follow-up visit. His past medical history is notable for impaired fasting glucose and
hypertension. His current medications include valsartan (Diovan), 160 mg daily;
rosuvastatin (Crestor), 20 mg daily; and aspirin, 81 mg daily. On examination his BMI is
30 kg/m2, his blood pressure is 134/86 mm Hg, and he has brown, velvety,
hyperkeratotic plaques on the back of his neck and in his axillae. Laboratory studies are
notable for an LDL-cholesterol level of 85 mg/dL, an HDL-cholesterol level of 35 mg/dL,
and a serum triglyceride level of 174 mg/dL. His hemoglobin A1c is 7.1%.
Which one of the following agents may reduce his risk for stroke and myocardial
infarction? - Answer-D. Pioglitazone (Actos)
/.4. A 71-year-old male is hospitalized for an infected foot ulcer. His medical history is
notable for type 2 diabetes, hypertension, and chronic pancreatitis. His medications on
admission include pancrelipase (Creon), 72,000 units with each meal; extended-release
metformin (Glucophage XR), 500 mg four times daily; extended-release glipizide
(Glucotrol XL), 5 mg daily; and benazepril (Lotensin), 40 mg daily. Insulin therapy is
initiated for hyperglycemia with persistent blood glucose levels ≥200 mg/dL.
Based on American Diabetes Association guidelines, which one of the following would
be the most appropriate glycemic target for this patient during his hospitalization? -
Answer-C. 140-180 mg/dL
/.5. An obese 53-year-old male with a history of type 2 diabetes sees you for the first
time. He tells you that his previous physician had him see a dietician and started him on
metformin (Glucophage), 500 mg twice daily. A copy of his most recent laboratory tests
shows a hemoglobin A1c of 7.7%. He tells you that he has always been sedentary and
asks if it would be worthwhile for him to join an exercise facility and begin an exercise
program.
Which one of the following statements would be accurate advice? - Answer-C.
Combined aerobic and resistance training results in greater glycemic improvement than
either method alone
, /.6. An overweight, sedentary 71-year-old male presents with a 4-month history of
burning pain in the soles of his feet that is most noticeable at night when he is lying in
bed. His medical history includes a long history of type 2 diabetes, hypertension, and
hypercholesterolemia. His current medications include metformin (Glucophage), 850 mg
twice daily; exenatide (Bydureon), 2 mg subcutaneously weekly; valsartan (Diovan), 360
mg daily; hydrochlorothiazide, 25 mg daily; and rosuvastatin (Crestor), 10 mg daily. He
quit smoking 40 years ago and does not drink alcohol. A physical examination is
unremarkable except for some hyperesthesia of both feet, as well as reduced vibratory
sensation. His protective sensation is intact in both feet and his pedal pulses are
normal.
Which one of the following would be LEAST effective for treating this patient's pain
syndrome? - Answer-B. SSRIs
/.7. A 71-year-old male presents early on a Saturday morning to the urgent care clinic
you are staffing. He describes a 1-week history of episodic sweating, feelings of hunger,
and tremor that are relieved by eating. He reports that he has type 2 diabetes and has
taken metformin (Glucophage) for years, and that his physician recently added a new
diabetes medication because his hemoglobin A1c rose above 7.5%. He did not bring his
medications with him and you are unable to access his records because the electronic
medical record system is undergoing routine maintenance and an update.
Which one of the following diabetes medications would be most likely to cause this
patient's symptoms? - Answer-C. Glyburide
/.8. A 55-year-old male with type 2 diabetes presents with a history of reduced libido
and erectile dysfunction. He has not seen a physician for many years. On examination
you note bronze-colored skin, hepatomegaly, and mild testicular atrophy. A nonfasting
laboratory workup reveals the following serum levels:
Glucose............250 mg/dL
AST............260 U/L (N 10-40)
ALT............210 U/L (N 10-55)
FSH............5.0 mIU/mL (N 1.0-12.0)
LH............8.1 mIU/mL (N 2.0-12.0)
Testosterone............180 ng/mL (N 280-1250)
Which one of the following is the most likely diagnosis? - Answer-D. Hemachromatosis
/.9. A 67-year-old male sees you 6 months after he was hospitalized with a non-ST-
elevation myocardial infarction. He also has a history of hypertension and type 2
diabetes. His current medications are rosuvastatin (Crestor), 40 mg daily; benazepril
(Lotensin), 20 mg daily; metoprolol, 25 mg twice daily; aspirin, 81 mg daily; and
clopidogrel (Plavix), 75 mg daily. His fasting lipid profile reveals a total cholesterol level
of 198 mg/dL, an LDL-cholesterol level of 70 mg/dL, an HDL-cholesterol level of 40
mg/dL, and a serum triglyceride level of 375 mg/dL.
Adding which one of the following agents is recommended by the American Diabetes
Association to further reduce his cardiovascular risk? - Answer-E. Icosapent ethyl
(Vascepa), 4 g daily
