Diabetes Mellitus: Pathophysiology & Clinical Guidelines

~ Exam ~

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1. Diabetes Mellitus can best be described as:

  a. an endocrine disorder resulting from an inadequate production or impaired use of insulin.

  b. a metabolic disorder primarily characterized by loss of protein in the urine.

  c. an endocrine disorder always resulting in blindness, kidney failure, and cardiovascular disease.

  d. an infectious disease process for which there is no cure.

2. Which of the following groups is considered to have the least risk of developing Type 2 diabetes?

  a. African-Americans

  b. Native Americans

  c. Hispanics

  d. Caucasians

3. The current upper limit of “normal” blood glucose level was chosen because:

  a. it is the point where vascular complications begin.

  b. it was necessary to diagnose more individuals.

  c. tests are most accurate at this level.

  d. OGTT and IFT are easily compared at this level.

4. Urine tests are a good measure of blood glucose levels.

  a. true

  b. false

5. A definitive diagnosis of diabetes can be based on:

  a. symptoms and a family history of diabetes.

  b. symptoms of diabetes, a positive family history and a single glucose test.

  c. a single oral glucose test in persons with a family history of any type of diabetes.

  d. two consecutive glucose tests on subsequent days duplicating a positive result.

6. Self-monitoring of blood glucose (SMBG) allows individuals to:

  a. treat infections.

  b. ascertain the presence of ketones in the urine.

  c. make changes in insulin/diet/exercise therapy.

  d. diagnose diabetes.

7. A glycated hemoglobin test (HbA1c) is likely to be recommended because:

  a. it accurately measures blood glucose levels over the past several months.

  b. it accurately measures blood glucose levels over the past several weeks.

  c. it is available over the counter.

  d. it is inexpensive.

8. Microvascular damage and high blood glucose can impair the body’s infection fighting ability.

  a. true

  b. false

9. The most common cause of death among individuals diagnosed with diabetes mellitus is:

  a. kidney failure

  b. stroke

  c. gangrene

  d. cardiovascular disease

10. The most common oral complication of diabetes is:

  a. glossitis.

  b. angular cheilitis.

  c. dental caries.

  d. periodontitis.

11. The severity of periodontal disease seen in diabetics is most likely attributed to:

  a. geographic location and decreased ability to find specialty care.

  b. reduced host response to microorganisms and decreased ability to fight infection.

  c. specific microflora only found in diabetics.

  d. xerostomia, candidiasis, and burning mouth syndrome.

12. Dental treatment for a controlled diabetic patient should be altered in the following way(s):

  a. no vasoconstrictors used.

  b. appointments should be longer allowing the diabetic individual to relax.

  c. be referred to a physician prior to any dental treatment.

  d. be treated the same as a nondiabetic patient for routine dental procedures.

13. It is better to schedule a diabetic’s dental appointment during:

  a. the lactose intolerance phase.

  b. high glucose and low insulin activity.

  c. low glucose and high insulin activity.

  d. second phase of the insulin regimen.

14. Doxycycline is a good choice for a diabetic because:

  a. diabetics need extra vitamin C.

  b. it is metabolized in the kidneys and not in the liver.

  c. it is less expensive than tetracycline.

  d. it is metabolized in the liver and not in the kidneys.

15. The most likely acute diabetic emergency in the dental office is:

  a. hypoglycemia.

  b. glucagon overdose.

  c. retinal dystrophy.

  d. kidney failure.

16. Which of the following is not a symptom of hypoglycemia?

  a. headache

  b. confusion

  c. dilated pupils

  d. ketone production

17. An extreme acute complication arising from chronic hyperglycemia is:

  a. kidney disease.

  b. blindness.

  c. neuropathy.

  d. hyperglycemic hyperosmolar nonketotic coma.

18. Diabetic Ketoacidosis:

  a. is sudden in onset.

  b. is a likely presenting symptom of an undiagnosed Type 1 diabetic.

  c. results from an insulin overdose.

  d. cannot be prevented.

19. When a dental practitioner is unsure of whether a diabetic emergency is related to hypoglycemia or hyperglycemia the best action to take is to:

  a. consult with the patient’s physician.

  b. follow the protocol for hypoglycemia.

  c. reappoint the patient.

  d. place patient in an upright position and apply cool cloth to their forehead.

20. High ketone levels in the urine can predict the onset of Hyperglycemic Hyperosmolar Nonketotic Coma.

  a. true

  b. false

21. Primary diabetic treatment goals are:

  a. controlling blood glucose levels and preventing complications with the disease.

  b. controlling blood glucose levels and improving diet and exercise regimen.

  c. controlling blood glucose levels and maintaining desirable body weight.

  d. nutrition counseling and exercise.

22. The 5 most important factors related to maintaining good blood glucose control include:

  a. eye exams, genetic counseling, insulin, education and regular dental visits.

  b. high protein diet, dental visits, exercise, OHAs and education.

  c. insulin, hospitalization, eye exams and a low sugar diet.

  d. education, diet, exercise, pharmaceutical intervention, and professional monitoring.

23. Oral diabetes medications (Oral Hypoglycemics) are prescribed for Type 1 diabetics because they can produce insulin but cannot use it correctly.

  a. true

  b. false

24. A diabetic may experience liver damage if they take:

  a. sufonylureas.

  b. biguanides.

  c. rezulin.

  d. insulin.

25. According to the Appendix entitled, “Estimated Percentage of Adults with Diagnosed Diabetes...”, Adults in California with the highest percent of diagnosed diabetes fell into what age group:

  a. 18-44

  b. 45-64

  c. 65-74

  d. 75 or older