E. Physical inactivity
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?
D. 200 mg/dL
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
, D. Pioglitazone (Actos)
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?
, C. 140-180 mg/dL
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?
, C. Combined aerobic and resistance training results in greater
glycemic improvement than either method alone
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?
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?
D. 200 mg/dL
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
, D. Pioglitazone (Actos)
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?
, C. 140-180 mg/dL
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?
, C. Combined aerobic and resistance training results in greater
glycemic improvement than either method alone
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?
