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Diabetes 2

Total questions: 20

Worksheet time: 20mins

Name
Class
Date
1.

An obese 65-year old woman was recently diagnosed with type 2 diabetes. She has a past medical history of hypertension, heart failure (New York Heart Association Class III), and chronic kidney disease. Her exam today reveal the following: A1C of 7.5%, serum creatinine 1.6mg/dL, estimated glomerular filtration rate (eGFR) 34ml/min, blood pressure 110/70 mm/Hg. Which of the following would be the best choice to improve her glycemic control?

a)

Canagliflozin

b)

Metformin XR

c)

Sitagliptin

d)

Rosiglitazone

2.

According to the American Diabetes Association (ADA), which drug therapy is recommended as the initial agent in patients with type 2 diabetes?

a)

Acarbose

b)

Sulfonylureas

c)

Metformin

d)

SGLT-2 inhibitors

3.

A 45-yer-old female patients is newly diagnosed with type 2 diabetes. Her A1C is 8.8%, her serum creatinine is 0.6% and her BMI is 22kg/m2. Which of the following drug therapy options would be MOST appropriate?

a)

Exenatide

b)

Saxagliptin

c)

Acarbose

d)

Metformin

4.

Which of he following agents is LEAST likely to cause hypoglycemia in an active adult?

a)

Glyburide

b)

Sitagliptin

c)

Repaglinide

d)

Regular Insulin

5.

A 54- year-old male with type 2 diabetes presents for follow-up on maximum dose metformin. He wants to lose weight but is also concerned about hypoglycemia. His A1C is 7.8% and his serum creatinine is 0.8%. Which of the following drug therapy options would be MOST appropriate?

a)

Sitagliptin

b)

Canagliflozin

c)

Glargine insulin

d)

Glulisine insulin

6.

A patient with an irregular meal schedule presents to the clinic for follow-up. He takes metformin 1 g twice daily and his current A1C is 7.4%. He reports drinking coffee for breakfast eating crackers for lunch, and eating a large evening meal when he comes home from work. Review of his self-monitored blood glucose records reveals elevated values after his large evening meal. Which of the following would be the best option to improved his glycemic control?

a)

Increase metformin

b)

add glargine insulin

c)

add nateglinide

d)

add glyburide

7.

Which of the following classes of medications is associated with fluid retention and edema?

a)

Biguanides

b)

Thazolidinediones

c)

DPP-4 inhibitors

d)

SGLT-2 inhibitors

8.

Which of the following laboratory test results meet the diagnostic criteria for prediabetes?

a)

Fasting plasma glucose of 79mg/dL

b)

A1C of 5.9%

c)

Random blood glucose 200mg/dl with polyuria, polydipsia, and polyphagia.

d)

Random blood glucose of 200mg/dL

9.

Acanthosis nigricans is associated with all of the following disorders except:

a)

obesity

b)

diabetes

c)

colon cancer

d)

tinea versicolor

10.

Which f the following laboratory test would you order for an older diabetic man with the following complete blood count (CBC) results: hemoglobin=11g/dL, hematocrit = 38%, mean corpuscular volume (MCV) = 105fL, and normal reticulocyte count?

a)

serum ferritin and peripheral smear

b)

hemoglobin electrophoresis

c)

serum folate acid and B12 level

d)

Schilling test

11.

Which of the following is characterized by the absence of warning sign of impending neuroglycopenia?

a)

severe hypoglycemia

b)

hypoglycemia unawareness

c)

multifocal neuropathy

d)

amyotrophy

12.

Which of the following is consistent with serum glucose of 734 mg/dL, loss of 13% body weight, lethargy, mild confusion, and negative ketone?

a)

Hyperosmolar hyperglycemic state (HHS)

b)

Diabetic ketoacidosis (DKA)

c)

Insufficient insulin in type 1 diabetes

d)

Streptocococcus infection

13.

A postal worker who walks a route every day is newly diagnosed with type 2 diabetes. Which of the following drug classes is MOST likely to cause hypoglycemic symptoms while he is delivering the mail?

a)

Meglitides

b)

Thiazolinediones

c)

Biguanides

d)

DDP-IV inhibitors

14.

A physician is considering adding metformin to a patient's regimen, but is unsure of how it improves glycemic control. Which of the following is the most appropriate description of the primary mechanism of action for metformin?

a)

Increased insulin sensitivity

b)

Inhibition of hepatic glucose release

c)

Delayed absorption of carbohydrates from the GI tract

d)

Enhanced insulin secretion from the islet cells of he pancreas

15.

Acarbose is added to glipizide to treat a patient with type 2 diabetes. Which of he following is the MOST appropriate recommendation to teat hypoglycemia in the this patient?

a)

Orange juice

b)

Low-fat or skim milk

c)

Hard candy

d)

Regular soda

16.

A 62- year old woman with a history of type 2 diabetes and cardiovascular disease contacts you for advice on exercise. Her GYN advised her to begin a resistance program following a recent diagnosis of osteopenia. Which of he following is the most appropriate exercise related recommendation for this patient?

a)

Check her blood pressure and pulse frequently during exercise

b)

Focus on aerobic exercise to strengthen her bones

c)

Hold her breath while lifting to stimulate coronary perfusion

d)

Complete repetitions as quickly as possible

17.

The most commonly reported disordered eating behavior in individual with type 2 diabetes is

a)

purging

b)

binging

c)

anorexia nervosa

d)

insulin omission to facilitate weight loss

18.

Karl is a 59-year old African American male with new-onset type 2 diabetes who is referred to you for instruction on self-monitoring of blood glucose. He brings his meter to the session and tells you that he has read the instruction manual and watched the video. however, he expresses concern regarding his ability to test his blood glucose levels twice a day as recommended. According to the transtheoretical model, in what stage is Karl?

a)

Contemplation

b)

Preparation

c)

Action

d)

Maintenance

19.

Which of the following islet cell antibodies is he best predictor of future type 1 diabetes?

a)

Heat shock protein 65

b)

Islet antigen A2 and A2 beta

c)

Glutamic acid decarboxylase

d)

Insulin autoantibodies

20.

A19-year old patient complains of unexplained weight loss and extreme hunger over the past month. Which of the following is he MOST useful information to confirm a diagnosis of diabetes?

a)

Patient reported polyuria

b)

A1C of 5.8%

c)

Fasting plasma glucose of 106 mg/dL

d)

Random plasma blood glucose >200 mg/dL with polyuria