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Worksheets

Path - Diabetes

Total questions: 65

Worksheet time: 36mins

Name
Class
Date
1.

Glucagon is secreted by which cells of the islets of Langerhans? [Massey's quiz]

a)

alpha

b)

F

c)

delta

d)

beta

2.

Hypoglycemia following by rebound hyperglycemia in the early morning hours is called: [Massey's quiz]

a)

Somogyi effect

b)

Diabetic coma

c)

DKA

d)

Dawn phenomenon

3.

Which pancreatic hormone is secreted by delta cells and functions to regulate alpha and beta cells ultimately causing hypoglycemia? [Massey's quiz]

a)

somatostatin

b)

insulin

c)

glucagon

d)

amylin

4.

Which of the following represent etiologies of diabetes mellitus? [Massey's quiz]

a)

endocrinopathies

b)

drug induced

c)

auotimmune destruction of the pancreas

d)

all of the above

5.

Peptide hormone cosecreted with insulin in response to nutrient stimuli that functions to delay gastric emptying and suppress glucagon secretion? [Massey's quiz]

a)

glucagon

b)

gastrin

c)

somatostatin

d)

amylin

6.

The transporter that allow for the diffusion of glucose into cells from the blood stream are: [Massey's quiz]

a)

pre-proinsulin

b)

GLUT 4

c)

Insulin receptor

d)

amylin

7.

Alternate cellular energy sources that produce ketones are: [Massey's quiz]

a)

glucose

b)

fatty acids

c)

amino acids

d)

glycogen

8.

Serum glucose concentrations are the highest in patients with: [Massey's quiz]

a)

Hypoglycemia

b)

Diabetic coma

c)

DKA

d)

HHNKS/HHS

9.

Which of the following is NOT characteristic of Type 2 DM? [Massey's quiz]

a)

history of longstanding obesity

b)

onset peaks between 40-50 years

c)

Severe insulin deficiency

d)

insulin secretion declines over time

10.

Which of the following diabetic complications presents with elevated serum glucose, volume depletion, and electrolyte deficiency? [Massey's quiz]

a)

DKA

b)

HHS

c)

DKA and HHS

d)

Hypglycemia

11.

Insulin is secreted by which cells of the islet of Langerhans? [Massey's quiz]

a)

F alpha beta

b)

alpha

c)

beta

d)

delta

12.

Which of the following meets the diagnostic criteria for pre-diabetes mellitus? [Massey's quiz]

a)

HbA1C of 6.0%

b)

Fasting blood glucose of 95

c)

2hr plasma glucose following OGTT of 125

d)

None of the answer meet the criteria

13.

Somatostatin is secreted by which cells of the islets of Langerhans? [Massey's quiz]

a)

pp cells

b)

delta cells

c)

alpha cells

d)

beta cells

14.

Peripheral neuropathy is more common in: [Massey's quiz]

a)

Renal failure

b)

Type 1 DM

c)

Type 2 DM

d)

Hepatic failure

15.

Which of the following meets the diagnostic criteria for diabetes mellitus? [Massey's quiz]

a)

2hr plasmsa glucose following OGTT of 150

b)

HbA1C of 6.0%

c)

Fasting blood glucose of 103

d)

Symptoms + random plasma glucose of 250

16.

islet of Langerhans cell types: Alpha cells secrete

a)

glucagon

b)

insulin

c)

amylin

d)

somatostatin

e)

gastrin

17.

islet of Langerhans cell types: Beta cells secrete

a)

glucagon

b)

insulin

c)

amylin

d)

somatostatin

e)

gastrin

18.

islet of Langerhans cell types: Delta cells secrete

a)

insulin

b)

amylin

c)

somatostatin

d)

gastrin

e)

pancreatic polypeptide

19.

islet of Langerhans cell types: F cells secrete

a)

insulin

b)

amylin

c)

somatostatin

d)

gastrin

e)

pancreatic polypeptide

20.

is processed through a secretory pathway (cleavage of C peptide to form mature form of insulin

a)

pre-proinsulin

b)

proinsulin

21.

GLUT4

a)

insulin dependent

b)

insulin independent

22.

declining blood glucose levels will prompt the pancreas to release ______ --> which will stimulate the liver to ________ --> blood glucose then rises to normal range

a)

glucagon ; glycogen breakdown

b)

glucagon ; glycogen formation

c)

insulin ; glycogen formation

d)

insulin ; glycogen breakdown

23.

rising blood glucose levels will prompt the pancreas to release ______ --> which will stimulate the liver to ________ --> which then stimulates _______ by tissue cells --> blood glucose then falls to normal range

a)

glucagon ; glycogen breakdown ; glucose release

b)

glucagon ; glycogen formation ; glucose uptake

c)

insulin ; glycogen formation ; glucose uptake

d)

insulin ; glycogen breakdown ; glucose release

24.

insulin

a)

anabolic hormone

b)

peptide hormone

25.

amylin

a)

anabolic hormone

b)

peptide hormone

26.

glucagon

a)

insulin antagonist

b)

insulin agonist

27.

glucagon

a)

stimulates glycogenolysis

b)

stimulates gluconeogenesis

c)

stimulates lipolysis (ketogenic)

d)

controls postprandial glucose levels

e)

stimulates GH secretion

28.

Incretions

a)

stimulates glycogenolysis

b)

stimulates gluconeogenesis

c)

stimulates lipolysis (ketogenic)

d)

controls postprandial glucose levels

e)

stimulates GH secretion

29.

amylin

a)

controls postprandial glucose levels

b)

stimulates GH secretion

c)

regulates blood glucose

d)

satiety effect

e)

antihyperglycemic effect

30.

Somatostatin

a)

Regulates pancreatic secretion activities

b)

Regulates alpha-cell and beta-cell function

c)

Likely controls the secretion of glucagon

d)

Stimulates GH secretion

e)

Inhibits glucose-stimulated insulin secretion

31.

Gastrin

a)

Regulates pancreatic secretion activities

b)

Regulates alpha-cell and beta-cell function

c)

Likely controls the secretion of glucagon

d)

Stimulates GH secretion

e)

Inhibits glucose-stimulated insulin secretion

32.

Ghrelin

a)

Regulates pancreatic secretion activities

b)

Likely controls the secretion of glucagon

c)

Stimulates GH secretion

d)

Inhibits glucose-stimulated insulin secretion

e)

Promotes gastric secretion and antagonizes cholecystokinin

33.

Pancreatic polypeptide

a)

Regulates pancreatic secretion activities

b)

Likely controls the secretion of glucagon

c)

Stimulates GH secretion

d)

Inhibits glucose-stimulated insulin secretion

e)

Promotes gastric secretion and antagonizes cholecystokinin

34.

Ghrelin: Levels _______ before a meal and stimulate _______

a)

increase ; appetite

b)

decrease ; appetite

c)

increase ; satiety

d)

decrease ; satiety

35.

Ghrelin: Levels ____ soon after a meal and promote feeling of ____

a)

fall ; appetite

b)

rise ; appetite

c)

fall ; satiety

d)

rise ; satiety

36.

How does Amylin regulate blood glucose?

a)

Delaying nutrient uptake

b)

Slows gastric emptying

c)

Inhibits digestive secretion (gastric acid, pancreatic enzymes, bile ejection)

d)

Suppressing glucagon secretion after meals

e)

Regulating alpha-cell and beta-cell function

37.

How do Incretions control post-prandial glucose?

a)

Promoting glucose-dependent insulin secretion

b)

Inhibiting glucagon synthesis

c)

Delaying gastric emptying

d)

Delaying nutrient uptake

38.

When is Glucagon secretion promoted?

a)

Decreased blood glucose levels

b)

Amino acids (alanine, glycine, asparagine)

c)

High protein meal

d)

Low carb meal

e)

Increased blood glucose levels

39.

______ levels of Glucagon relative to Insulin contribute to Hyperglycemia and Hyperketonemia

a)

High

b)

Low

40.

-Environmental and genetic factors trigger cell-mediated destruction of pancreatic beta cells.

-Autoantibody, T-cell, and macrophage destruction of pancreatic beta cells occur with a loss of insulin production and a relative excess of glucagon

a)

Autoimmine (type 1A)

b)

Nonimmune (type 1B)

41.

Occurs secondary to other diseases, such as pancreatitis, also termed idiopathic diabetes.

a)

Autoimmine (type 1A)

b)

Nonimmune (type 1B)

42.

Obesity is a major contributor to insulin resistance in Type 2 Diabetes Mellitus by:

a)

Alteration in the production of adipokines by adipose tissue

b)

Elevated serum free fatty acids and intracellular lipid deposits

c)

Release of inflammatory cytokines from adipose tissue

d)

Reduced insulin-stimulated mitochondrial activity

e)

Lymphocyte and macrophage infiltrating islets

43.

clinical manifestations for Type 1 DM

a)

polydipsia

b)

polyuria

c)

polyphagia

d)

weight loss

e)

recurrent infections

44.

clinical manifestations for type 2

a)

recurrent infections & prolonged wound healing

b)

genital pruritis

c)

visual changes

d)

parathesias

e)

acanthosis nigricans

45.

clinical manifestation seen in both Type 1 and Type 2 DM

a)

weight loss

b)

fatigue

c)

recurrent infections

d)

prolonged wound healing

46.

Since there is such a rise in type 2 diabetes, it is recommended that high-risk women who are found to have diabetes at their initial prenatal visit receive a diagnosis of _________.

a)

Overt Diabetes

b)

Type 2 DM

c)

Gestational Diabetes Mellitus

47.

Fluid accumulation and retinal thickening near the center of the macula is the leading cause of vision loss among persons with diabetes. ***

a)

True

b)

False

48.

Diabetic Retinopathy is characterized by: Maculopathy =

a)

Progressive process that accompanies retinal capillary permeability, vessel occlusion, ischemia

b)

Fluid accumulation and retinal thickening

49.

Thickening of retinal capillary basement membrane and increase in retinal capillary permeability, vein dilation, micro-aneurysm, superficial hemorrhages

a)

NonProliferative

b)

Preproliferative

c)

Proliferative

50.

Progression of retinal ischemia → infarcts

a)

NonProliferative

b)

Preproliferative

c)

Proliferative

51.

Neovascularization -- Newly formed vessels may cause retinal detachment or hemorrhage into vitreous humor.

a)

NonProliferative

b)

Preproliferative

c)

Proliferative

52.

Is a consequence of accelerated atherosclerosis, hypertension, and increased risk for thrombus formation.

a)

Coronary Artery DIsease

b)

Stroke

c)

Diabetic Retinopathy

d)

Diabetic Nephropathy

e)

Infection

53.

Is a disease in the capillaries caused by diabetes

a)

microvascular disease

b)

macrovascular disease

c)

infection

54.

Lesions develop in large- and medium-sized arteries from hyperglycemia.

a)

microvascular disease

b)

macrovascular disease

c)

infection

55.

Characteristics of microvascular disease

a)

Thickening of the capillary basement membrane, endothelial cell hyperplasia, thrombosis, and pericyte degeneration → Emerge in 1-2 years

b)

Hyperglycemia (must be present)

c)

Hypoxia and ischemia-particularly in the retina, kidney and nerves

d)

Advanced glycation end-products (AGE) attach to their receptor for AGE (RAGE) in the walls of blood vessels

e)

Promotes oxidative stress, inflammation, endothelial and vascular smooth muscle dysfunction, and hyperlipidemia

56.

Macrovascular disease:

a)

Thickening of the capillary basement membrane, endothelial cell hyperplasia, thrombosis, and pericyte degeneration → Emerge in 1-2 years

b)

Hyperglycemia (must be present)

c)

Hypoxia and ischemia-particularly in the retina, kidney and nerves

d)

Advanced glycation end-products (AGE) attach to their receptor for AGE (RAGE) in the walls of blood vessels

e)

Promotes oxidative stress, inflammation, endothelial and vascular smooth muscle dysfunction, and hyperlipidemia

57.

Early morning glucose elevation without nocturnal hypoglycemia

a)

Somogyi effect

b)

DKA

c)

HHS

d)

Dawn phenomenon

58.

Glucose: Often more than 600 mg/dl ***

a)

DKA

b)

HHS

59.

Serum glucose level >250 mg/dl ***

a)

DKA

b)

HHS

60.

Presence of urine and serum ketones

a)

DKA

b)

HHS

61.

Elevated glucose levels: More pronounced in ____

a)

DKA

b)

HHS

62.

Fluid deficiency: More marked in ____

a)

DKA

b)

HHS

63.

Insulin deficiency: More profound in DKA

a)

DKA

b)

HHS

64.

Serum bicarbonate level <18 mg/dl

Serum pH <7.30

a)

DKA

b)

HHS

65.

Normal bicarbonate and pH

a)

DKA

b)

HHS

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