- Email: [email protected]
CME test questions
1. Type 1 diabetes, also known as IDDM, is a chronic autoimmune disease resulting from a complex interaction of both and factors. a. genetic and viral b. genetic and environmental c. humoral and environmental d. genetic and humoral 2. Mutation array of including immune a. True b. False
c. obesity d. molecular mimicry 6. The emerging epidemic of type 2 diabetes in youth is a result of all of the following except a. increased obesity b. decreased activity c. increased incidence of hyperglycemia d. genetic predisposition
of a single gene can give rise to an autoimmune polyendocrine disorders, insulin-dependent diabetes of autoorigin.
7. Data have demonstrated a relationship impaired insulin secretion and a. increased body weight and fat mass b. hyperglycemia c. neither a nor b d. both a and b
3. Factors that may play a role in the development of type 1 diabetes include all of the following except a. genetic susceptibility b. a virus such as coxsackievirus c. hyperglycemia d. molecular mimicry
between
8. Lifestyle changes (ie, a healthy diet and exercise) can prevent progression from IGT to type 2 diabetes. a. True b. False 9. Relative to peripheral fat tissue, visceral fat is ~ to the metabolic effects of insulin and to the metabolic effects of lipolytic hormones such as glucocorticoids and catecholamines. a. less resistant and less sensitive b. less resistant and more sensitive c. more resistant and less sensitive d. more resistant and more sensitive
4. The number of type 2 diabetic patients is currently increasing as a result of a. increased life expectancy b. increased incidence of obesity c. increased awareness and disease diagnosis d. b and c 5. The most common form of type 2 diabetes is a heterogenous disorder caused by a dual defect involving beta cell dysfunction and a. genetic mutation b. insulin resistance
10. Which of the following is not true? a. Hyperinsulinemia is a predictor of ischemic heart disease.
66
clinical CORNERSTONE
b. There is a relationship between carotid artery atherosclerosis, angina, and hyperinsulinemia. c. Hyperinsulinemia is not a predictor of elevated BP in children. d. Hyperinsulinemia predisposes patients to hypertension, ischemic heart disease, and stroke.
DlABETES
.
Vol. 4 No. 2
not be warranted. a. True b. False 16. Persons with diabetes and hypertension increased risk of a. microvascular complications b. macrovascular complications c. a and b d. neither a nor b
11. In persons with insulin resistance and visceral obesity, defects in the normal vascular actions of insulin include which of the following? a. Resistance to insulin-mediated glucose uptake b. Decreased insulin stimulation of blood flow c. Marked attenuation in the ability of insulin to decrease aortic wave reflection d. All of the above
have an
17. Two large CV secondary prevention trials showed that in patients with diabetes statin therapy lowers LDL-C a. to target levels b. to prediabetic levels c. as effectively as in patients without diabetes d. as effectively as in patients with hypertension
12. Visceral obesity and insulin resistance are associated with increased levels of a. angiotensin II b. C-reactive protein c. PAId. all of the above
18. The risk of a CV event in a person with diabetes is equal to that in a person a. without diabetes b. with CAD c. with hypertension d. with a history of stroke
13. Microalbuminuria represents a significant risk factor for CVD, including premature ischemic heart disease and stroke, and is also a risk factor for progressive renal disease in individuals with and without diabetes mellitus. a. True b. False 14. Diabetes and the risk of complications controlled through a. glucose management b. BP management c. lipid management d. lifestyle management e. all of the above
.
19. The weight-loss diet with the best chance of success for patients with type 2 diabetes provides a daily caloric reduction of a. 100 to 200 kcal b. 300 to 400 kcal c. 500 to 600 kcal d. 700 to 800 kcal
must be
20. An especially useful agent in the pharmacologic treatment of the obese patient with type 2 diabetes that avoids weight increase is a. glyburide b. repaglinide c. metformin d. rosiglitazone
15. Although intensive glycemic control reduces microvascular complications, the high costs associated with this aggressive therapy may
67
clinical CORNERSTONE
1
DIABETES
1 Vol.4 No. 2
a. b. c. d.
21. The two medications most commonly selected as initial monotherapy in type 2 diabetes are a. sulfonylurea and metformin b. sulfonylurea and insulin c. metformin and insulin d. none of the above
NPH Lente@ Ultralente@ insulin glargine
26. Which of the following regimens is the most practical and widely used replacement therapy for patients with type 1 diabetes? a. Twice-daily split-mixed regimen b. MD1 regimen c. Insulin pump therapy
22. If the combination of 2 oral agents fails to maintain adequate glycemic control in type 2 diabetes, it is best to a. try a different combination of 2 oral agents b. add a third oral agent c. add insulin to the oral agents d. replace the oral agents with insulin
27. The optimal approach for insulin therapy in obese type 2 patients is to exclude oral agents and institute insulin monotherapy. a. True b. False
23. For the hypertensive patient with type 2 diabetes and other CV complications, the best antihypertensive agent is a. a diuretic b. an ACE inhibitor c. a P-blocker d. any of the above
28. Initiation of insulin therapy in patients with type 2 diabetes should be delayed as long as possible because of the associated CV risk. a. True b. False
24. The ideal insulin replacement therapy for both type 1 and type 2 diabetes is a. basal/bolus regimen b. premeal short-acting premixed 70/30 or 75/25 insulin preparations c. twice-daily split-mixed regimen
29. Recent changes in the management of type 2 diabetes include a. early use of supplemental basal insulin b. greater use of combination therapy c. discontinuance of the use of insulin sensitizers d. low doses of insulin secretagogues e. a, b, and d
25. The ideal insulin replacement agent for regulating blood glucose levels during the night and between meals may be
68
c. obesity d. molecular mimicry 6. The emerging epidemic of type 2 diabetes in youth is a result of all of the following except a. increased obesity b. decreased activity c. increased incidence of hyperglycemia d. genetic predisposition
of a single gene can give rise to an autoimmune polyendocrine disorders, insulin-dependent diabetes of autoorigin.
7. Data have demonstrated a relationship impaired insulin secretion and a. increased body weight and fat mass b. hyperglycemia c. neither a nor b d. both a and b
3. Factors that may play a role in the development of type 1 diabetes include all of the following except a. genetic susceptibility b. a virus such as coxsackievirus c. hyperglycemia d. molecular mimicry
between
8. Lifestyle changes (ie, a healthy diet and exercise) can prevent progression from IGT to type 2 diabetes. a. True b. False 9. Relative to peripheral fat tissue, visceral fat is ~ to the metabolic effects of insulin and to the metabolic effects of lipolytic hormones such as glucocorticoids and catecholamines. a. less resistant and less sensitive b. less resistant and more sensitive c. more resistant and less sensitive d. more resistant and more sensitive
4. The number of type 2 diabetic patients is currently increasing as a result of a. increased life expectancy b. increased incidence of obesity c. increased awareness and disease diagnosis d. b and c 5. The most common form of type 2 diabetes is a heterogenous disorder caused by a dual defect involving beta cell dysfunction and a. genetic mutation b. insulin resistance
10. Which of the following is not true? a. Hyperinsulinemia is a predictor of ischemic heart disease.
66
clinical CORNERSTONE
b. There is a relationship between carotid artery atherosclerosis, angina, and hyperinsulinemia. c. Hyperinsulinemia is not a predictor of elevated BP in children. d. Hyperinsulinemia predisposes patients to hypertension, ischemic heart disease, and stroke.
DlABETES
.
Vol. 4 No. 2
not be warranted. a. True b. False 16. Persons with diabetes and hypertension increased risk of a. microvascular complications b. macrovascular complications c. a and b d. neither a nor b
11. In persons with insulin resistance and visceral obesity, defects in the normal vascular actions of insulin include which of the following? a. Resistance to insulin-mediated glucose uptake b. Decreased insulin stimulation of blood flow c. Marked attenuation in the ability of insulin to decrease aortic wave reflection d. All of the above
have an
17. Two large CV secondary prevention trials showed that in patients with diabetes statin therapy lowers LDL-C a. to target levels b. to prediabetic levels c. as effectively as in patients without diabetes d. as effectively as in patients with hypertension
12. Visceral obesity and insulin resistance are associated with increased levels of a. angiotensin II b. C-reactive protein c. PAId. all of the above
18. The risk of a CV event in a person with diabetes is equal to that in a person a. without diabetes b. with CAD c. with hypertension d. with a history of stroke
13. Microalbuminuria represents a significant risk factor for CVD, including premature ischemic heart disease and stroke, and is also a risk factor for progressive renal disease in individuals with and without diabetes mellitus. a. True b. False 14. Diabetes and the risk of complications controlled through a. glucose management b. BP management c. lipid management d. lifestyle management e. all of the above
.
19. The weight-loss diet with the best chance of success for patients with type 2 diabetes provides a daily caloric reduction of a. 100 to 200 kcal b. 300 to 400 kcal c. 500 to 600 kcal d. 700 to 800 kcal
must be
20. An especially useful agent in the pharmacologic treatment of the obese patient with type 2 diabetes that avoids weight increase is a. glyburide b. repaglinide c. metformin d. rosiglitazone
15. Although intensive glycemic control reduces microvascular complications, the high costs associated with this aggressive therapy may
67
clinical CORNERSTONE
1
DIABETES
1 Vol.4 No. 2
a. b. c. d.
21. The two medications most commonly selected as initial monotherapy in type 2 diabetes are a. sulfonylurea and metformin b. sulfonylurea and insulin c. metformin and insulin d. none of the above
NPH Lente@ Ultralente@ insulin glargine
26. Which of the following regimens is the most practical and widely used replacement therapy for patients with type 1 diabetes? a. Twice-daily split-mixed regimen b. MD1 regimen c. Insulin pump therapy
22. If the combination of 2 oral agents fails to maintain adequate glycemic control in type 2 diabetes, it is best to a. try a different combination of 2 oral agents b. add a third oral agent c. add insulin to the oral agents d. replace the oral agents with insulin
27. The optimal approach for insulin therapy in obese type 2 patients is to exclude oral agents and institute insulin monotherapy. a. True b. False
23. For the hypertensive patient with type 2 diabetes and other CV complications, the best antihypertensive agent is a. a diuretic b. an ACE inhibitor c. a P-blocker d. any of the above
28. Initiation of insulin therapy in patients with type 2 diabetes should be delayed as long as possible because of the associated CV risk. a. True b. False
24. The ideal insulin replacement therapy for both type 1 and type 2 diabetes is a. basal/bolus regimen b. premeal short-acting premixed 70/30 or 75/25 insulin preparations c. twice-daily split-mixed regimen
29. Recent changes in the management of type 2 diabetes include a. early use of supplemental basal insulin b. greater use of combination therapy c. discontinuance of the use of insulin sensitizers d. low doses of insulin secretagogues e. a, b, and d
25. The ideal insulin replacement agent for regulating blood glucose levels during the night and between meals may be
68