Diabetes Mellitus

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Chapter I Questions
1. The incidence of diabetes is high. There are more than ________ new cases diagnosed each year.

  a. 70,000
  b. 700,000
  c. 16,000
  d. 160,000
2. Insulin is a hormone produced by the pancreas. In diabetes, the pancreas either produces:
  a. No insulin.
  b. Too little insulin.
  c. The body does not respond to insulin.

  d. All of the above.

3. Insulin is produced in which islet cells?
  a. Beta cells
  b. Alpha cells
  c. PP cells

4. Factors that increase the risk of diabetes include:

  a. Obesity.
  b. Faulty immune system.
  c. Age.
  d. All of the above.
Chapter II Questions
5. In Type I diabetes:
  a. The body does not produce insulin.
  b. Not enough insulin is produced.
6. In Type I diabetes, the onset can be described as:
  a. Sudden
  b. Insidious
7. Type I diabetes symptoms are caused by:
  a. Hyperglycemia.
  b. Breakdown of body fats.
  c. Absence of insulin.
  d. All of the above.
8. Factors that increase the risk of DKA include:
  a. Failure to take insulin.
  b. Infection.
  c. Resistance to endogenous insulin.
  d. All of the above.
9. In Type 2 diabetes:
  a. Insulin is not produced.
  b. Not enough insulin is produced to transport glucose.

10. Warning signs of Type 2 diabetes include:
  a. Sudden onset.
  b. Weight loss.
  c. Polydipsia.
  d. All of the above.
  e. None of the above.
11. Patients with __________ will have blood sugars greater than 900 mg/100ml.
  a. HHNC
  b. DKA
12. Patients in ________ have sufficient circulating insulin to retard the release of fatty acids.
  a. HHNC

  b. DKA
13. Symptom of hypoglycemia include:
  a. Kussmaul respirations.
  b. Onset hrs. to days.
  c. Negative for glucose.

14. The prevalence of Type 2 diabetes is:
  a. 85-90%
  b. ½ of all cases
  c. 10-20%

Chapter III Questions
15. The normal range for fasting blood glucose is:
  a. Less than 140 mg/dl
  b. 70-110mg/dl
  c. 60-90 mg/dl

16. In a normal individual, after ingestion of glucose, the plasma glucose level returns to baseline within:
  a. 2 hours
  b. 4 hours
  c. 6 hours

17. The oral GTT begins with the patient in a fasting state for:

  a. 24 hours.
  b. Between 10-16 hours.
  c. A fasting state is not necessary.

18. The most sensitive test of carbohydrate tolerance is:
  a. OGTT.
  b. FPG.

  c. Cortisone GTT.
19. The test that measures average blood levels over the past 2 to 3 months is called:

  a. SMBG.
  b. Hemoglobin Alc.
20. __________ measures precisely the effects of changes in diet, exercise, and insulin dosage as they relate to blood glucose levels.
  a. SMBG
  b. Hemoglobin A1c
  c. RBS
21. Testing for ketones in the urine is appropriate for ____________ diabetes.
  a. Type I
  b. Type II
Chapter IV Questions
22. Premixed insulin is a combination of specific proportions of:
  a. Short acting and intermediate insulin.
  b. Short acting and long acting insulin.

23. __________ should be clear and colorless.
  a. Semi-Lente insulin.
  b. Regular insulin.
  c. NPH insulin.
24. _____ is used to lower blood sugar quickly when immediate action is needed.

  a. Regular insulin.
  b. NPH insulin.
  c. Lispro.
25. When mixing two different insulins in one syringe, __________ is drawn into the syringe first.
  a. NPH.
  b. Regular.
  c. Lente.
  d. Lispro.

26. Insulin absorption can be affected by:
  a. Environmental temperatures.
  b. Depth of injection.
  c. Exercise.
  d. All of the above.
27. An insulin reaction is the body’s response to:

  a. Low blood sugar.
  b. High blood sugar.
28. Oran Antidiabetic agents are used in the treatment of:
  a. Type I diabetes.
  b. Type II diabetes.

29. __________ help put more insulin into the blood stream.
  a. Sulfonylureas.
  b. Alpha-glucosidase.
  c. Biguanides.
30. Treatment with ________ can only be effective in patients with reserve beta cell function.
  a. Sulfonylureas.
  b. Alpha=glucosidase.
  c. Biguanides.
31. The average weight gain for patients on sulfonylureas is:
  a. 2-3 pounds.
  b. No weight gain.
  c. 10 – 15 pounds.

32. Prandin is most effective when taken:
  a. 30 minutes before meals.
  b. 30 minutes after meals.
  c. During meals.

33. Lactic acidosis is a side effect of which drug:
  a. Prandin.
  b. Metformin.
  c. Precose.
34. Symptoms of lactic acidosis include all except:
  a. Malaise.
  b. Nausea.
  c. Shortness of breath.
  d. Weakness.
35. __________ decreases the production of glucose by the liver.
  a. Alpha-glucosidase.
  b. Biguanide.
  c. TZDs.
36. __________ interfers with the absorption of glucose.
  a. TZDs
  b. Alpha-glucosidase
  c. Sulfonylureas
37. Indicate which statement is correct.
  a. Acarbose decreases digestion of carbohydrates.
  b. Acarbose increases digestive of carbohydrates.
38. __________ reduces the body’s resistance to insulin
  a. Biguanide.
  b. TZDs.
  c. Sulfonylureas.

Chapter V Questions
39. No more than __________ of calories should come from fat.
  a. 50%
  b. 20%
  c. 30%
  d. 10%

40. It is better for the diabetic to:
  a. Space meals throughout the day.

  b. Eat two main meals per day.

41. Saturated fat can be defined as:
  a. Vegetable fat that lowers cholesterol.

  b. Animal fat that raises blood cholesterol.

42. Low-density lipoprotein:
  a. Protects against heart disease.
  b. Deposits on artery walls, increases heart disease.

43. One serving of starch, fruit, or milk contains __________ grams of carbohydrates.
  a. 30
  b. 10
  c. 15
  d. 25
44. Approximately __________ of the total number of calories consumed should come from protein.
  a. 10%
  b. 30%
  c. 20%
  d. 50%

45. One pound of fat is equal to __________ calories.
  a. 3500 calories.
  b. 500 calories.
  c. 2500 calories.
  d. 2000 calories.

Chapter VI Questions
46. __________ of all diabetic admissions are the result of foot problems.
  a. 50%
  b. 10%
  c. 30%
  d. 20%
47. A sign of neuropathy in the early stages includes:
  a. Loss of sensation in lower limbs.
  b. Burning pain on the bottom of the foot.

48. Charcot arthropathies are micro-fractures in the feet resulting from:
  a. Loss of sensation.
  b. Deformities of the feet.
  c. Hyper-sensation of the feet.

49. Wounds on the medial aspect of the foot are caused by:
  a. Repetitive moderate pressure.
  b. Constant low pressure.
50. Signs of PVD include all except:
  a. Alleviation of pain with elevation of limb.
  b. Atrophic shiny skin.
  c. Non-palpable pedal pulse.
  d. Pallor or elevation of limbs.
Chapter VII Questions
51. Loss of motor fibers cause muscle weakness, Diabetic amyotrophy is centered in the:
  a. Pelvic girdle and thigh muscles.
  b. Lumbar region.
  c. Lower legs and feet.
52. __________is the most frequently diagnosed type of neuropathy
  a. Femoral neuropathy.
  b. Distal neuropathy.

53. Gastroparesis affects the stomach, and is what type of neuropathy?
  a. Motor neuropathy.
  b. Sensory neropathy.
  c. Autonomic neuropathy.
54. Bladder neuropathy is treated with
  a. Mexitil
  b. Elavil
  c. Urecholine

55. Carpal tunnel syndrome is an example of:
  a. A motor neuropathy.
  b. Compression mononeuropathy.
  c. Autonomic neuropathy.

56. Thoracic or lumbar radiculopathy occurs most often in people with:
  a. Type I diabetes.
  b. Type II diabetes.
57. Background retinopathy affects approximately _____ of long-term diabetics.
  a. 90-95%.
  b. 10-15%.
  c. 40-50%.

58. The __________is responsible for central vision and color vision.
  a. Macula.
  b. Lens.
  c. Vitreous.
59. If macular edema is suspected, the physician may order:
  a. Vitrectomy.
  b. Fluorescein angiography.
  c. Tonometry.

60. Laser treatment is used for:

  a. Glaucoma.
  b. Cataracts.
  c. Macular edema.
61. People with diabetes are _________more likely to develop ESRD than non-diabetics.
  a. 20 times.
  b. 10 times.
  c. 30 times.

62. Peritonitis, a complication of peritoneal dialysis, occurs if:
  a. The opening in the skin near the catheter becomes infected.
  b. The catheter bag is connected or disconnected incorrectly.
  c. A and B.

  d. Neither A or B.

63. There are three different types of peritoneal dialysis available. Which is the most common?
  a. CAPD.
  b. CCPD.
  c. IPD.
64. The new kidney is placed:
  a. In the lower back.
  b. Between the thigh and upper abd.
  c. In the lower abd.
65. Immunosuppressant drugs are given to help prevent rejection, These drugs are taken:
  a. Only until the new kidneys start working.
  b. For the rest of the patient’s life.
  c. For one year after implantation.
Chapter VIII Questions
66. If the child has gym or a sports activity, the child should have as a snack:
  a. A fast acting-sugar.
  b. Carbohydrate and protein.
  c. Nothing extra if the child feels well.

67. The written plan should be updated:
  a. Only as needed.
  b. Every year.
  c. As needed during the year and every new school year.

Chapter IX Questions
68. The diabetic patient must understand many different aspects of the disease. Which statement is false?
  a. Diabetes care requires a daily effort to follow a diet, stay active, and take medication.
  b. Depression can be a very debilitating emotion.
  c. It is possible to achieve perfect glycemic conrol.
  d. A newly diagnosed diabetic may feel confused and overwhelmed.