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Worksheets

Diabetes and Obesity

Total questions: 90

Worksheet time: 1hrs 8mins

Name
Class
Date
1.

Stress hyperglycemia is primarily driven by which hormones?

a)

Thyroid

b)

Counter-regulatory

c)

Gonadotropins

d)

Mineralocorticoids

2.

Counter-regulatory hormones in stress hyperglycemia include cortisol, catecholamines, glucagon and:

a)

Prolactin

b)

Melatonin

c)

Growth hormone

d)

Aldosterone

3.

A key metabolic defect in stress hyperglycemia is:

a)

Increased glucose utilization

b)

Decreased lipolysis

c)

Increased glucose production

d)

Increased insulin secretion

4.

Admission glucose 250 mg/dL\ge 250\ \text{mg/dL} in pneumonia increases mortality and:

a)

Stroke

b)

Arrhythmia

c)

Hospital complications

d)

Renal stones

5.

Hyperglycemia ( >200 mg/dL>200\ \text{mg/dL} \u00d72) occurs in hospitalized patients in:

a)

10%

b)

20%

c)

38%

d)

75%

6.

Newly discovered hyperglycemia is associated with:

a)

Shorter stay

b)

Lower ICU use

c)

Longer hospital stay

d)

Minimal impact

7.

Hyperglycemia significantly increases risk of:

a)

Viral infections

b)

Fungal infections

c)

Bacterial infections

d)

Parasitic infections

8.

Poor wound healing in hyperglycemia is largely due to impaired:

a)

Lymphatics

b)

Coagulation

c)

Tissue perfusion

d)

Bone turnover

9.

Hospital hyperglycemia is strongly linked to which condition(s)?

a)

Dementia

b)

Osteoporosis

c)

MI, Stroke, Trauma

d)

IBS

10.

Stress hyperglycemia vs. newly diagnosed diabetes can be differentiated by:

a)

Electrolytes

b)

CRP

c)

HBA1c

d)

Insulin level

11.

NICE-SUGAR recommends glucose target in ICU:

a)

80110

b)

100130

c)

140180

d)

200250

12.

Intensive insulin therapy increases:

a)

Hypernatremia

b)

Stroke

c)

Hypoglycemia

d)

Hyperkalemia

13.

NICE-SUGAR showed higher 90-day mortality in:

a)

Intensive glucose control group

b)

Conventional glucose control group

c)

Placebo group

d)

Non-diabetic subgroup

14.

AACE–ADA recommends initiating insulin therapy when glucose exceeds

a)

120120 mg/dL

b)

150150 mg/dL

c)

180180 mg/dL

d)

250250 mg/dL

15.

Recommended ICU glucose target (AACE–ADA)

a)

<110<110 mg/dL

b)

110110140140 mg/dL

c)

140140180180 mg/dL

d)

> 180180 mg/dL

16.

WHO defines obesity primarily as excess

a)

Protein

b)

Water

c)

Fat

d)

Bone

17.

BMI obesity cutoff (WHO)

a)

2323

b)

2525

c)

2727

d)

3030

18.

BMI obesity cutoff (Asian)

a)

2525

b)

3030

c)

3535

d)

2828

19.

ABCD stands for Adiposity-Based

a)

Cardiac Disease

b)

Chronic Disease

c)

Chemical Disorder

d)

Cellular Dysfunction

20.

Waist circumference is used to assess

a)

Bone mass

b)

Abdominal fat

c)

Muscle mass

d)

Hydration

21.

Y–Y Paradox highlights mismatch between BMI and

a)

Water

b)

Fat %

c)

Protein

d)

Glycogen

22.

Most accurate body composition method

a)

Tape measure

b)

DXA

c)

Skinfolds

d)

Impedance

23.

ORCD stands for Obesity-Related

a)

Cardiac Disorders

b)

Complications & Diseases

c)

Chronic Distress

d)

Circulatory Deficit

24.

Obesity complication: metabolic

a)

Psoriasis

b)

PCOS

c)

COPD

d)

Anxiety

25.

For OA, required weight loss is around

a)

5%5\%

b)

10%10\%

c)

20%20\%

d)

1%1\%

26.

Bariatric surgery typical weight loss

a)

About 10%10\% of baseline weight

b)

About 20%20\% of baseline weight

c)

About 30%30\% of baseline weight

d)

About 50%50\% of baseline weight

27.

Pharmacotherapy expected loss

a)

1%

b)

3%

c)

5–15%

d)

30%

28.

Most potent incretin for weight loss

a)

Orlistat

b)

Semaglutide

c)

Metformin

d)

Spironolactone

29.

Tirzepatide mechanism

a)

GLP-1 only

b)

GIP only

c)

GLP-1 + GIP

d)

GLP-2

30.

Mean weight loss with tirzepatide (obesity, no diabetes)

a)

5%

b)

9%

c)

15–21%

d)

30%

31.

Retatrutide activates GLP-1, GIP and

a)

Cortisol

b)

Glucagon receptor

c)

GH receptor

d)

Leptin receptor

32.

Orforglipron is the first oral non-peptide

a)

DPP-4 inhibitor

b)

GLP-1 agonist

c)

Insulin mimetic

d)

Lipase blocker

33.

CagriSema combines semaglutide +

a)

Orlistat

b)

Cagrilintide

c)

Phentermine

d)

Lorcaserin

34.

GLP-1 agonists reduce

a)

MI risk

b)

TSH

c)

Sodium

d)

Calcium

35.

GLP-1 slows

a)

Heart rate

b)

Gastric emptying

c)

Bone turnover

d)

Muscle growth

36.

BELIEVE trial combo was semaglutide +

a)

Liraglutide

b)

Bimagrumab

c)

Metformin

d)

Sitagliptin

37.

Bimagrumab preserves

a)

Fat

b)

Lean mass

c)

Water

d)

Bone

38.

Median diabetes-free survival after gastric bypass is:

a)

3 years

b)

5 years

c)

8.3 years

d)

12 years

39.

Higher chance of diabetes remission is associated with:

a)

Older age

b)

Longer diabetes duration

c)

Shorter diabetes duration

d)

Insulin treatment

40.

Higher visceral fat is linked with:

a)

Better remission

b)

Worse remission

c)

No change

d)

Higher cure rate

41.

Perioperative mortality of metabolic surgery is:

a)

0.01 %

b)

0.1–0.5 %

c)

1 %

d)

5 %

42.

Early dumping syndrome usually starts:

a)

1–5 minutes

b)

10–30 minutes

c)

1 hour

d)

3 hours

43.

Late dumping syndrome usually starts:

a)

10 minutes

b)

20 minutes

c)

1–3 hours

d)

10 hours

44.

Main driver of late post-surgical hypoglycemia is:

a)

Slow carbohydrate absorption

b)

Excess endogenous hormone surge

c)

Low cortisol

d)

Low insulin

45.

Post-surgical hypoglycemia risk is highest after:

a)

1 month

b)

3 months

c)

More than 1 year

d)

10 years

46.

First-line management of post-surgical hypoglycemia is:

a)

Insulin

b)

Carbohydrate reduction

c)

Steroids

d)

Glucagon

47.

Substance use increases the risk of:

a)

Rapid healing

b)

Surgical complications

c)

Iron overload

d)

Bone pain

48.

Surgery should be postponed in individuals with:

a)

Mild anxiety

b)

Active depression

c)

Resolved psychiatric issues

d)

Mild reflux

49.

Hormone-based anti-obesity medications can be used:

a)

Only before surgery

b)

Only after surgery

c)

Before or after surgery

d)

Not at all

50.

The only currently approved short-term weight-loss device is the gastric:

a)

Band

b)

Balloon

c)

Suction tube

d)

Stimulator

51.

Five-year diabetes remission after gastric bypass is:

a)

10 %

b)

33.1 %

c)

41.6 %

d)

60 %

52.

Five-year diabetes remission after sleeve gastrectomy is:

a)

10 %

b)

16.1 %

c)

33 %

d)

50 %

53.

Hormone-based medications after surgery help treat:

a)

Gastroparesis

b)

Weight regain

c)

Hypothyroidism

d)

Vitamin deficiency

54.

Micronutrient and metabolic monitoring after surgery should be:

a)

None

b)

Short-term

c)

Long-term

d)

Once yearly

55.

Metabolic surgery should be performed in centers with:

a)

Single surgeon

b)

Interprofessional teams

c)

Radiology only

d)

Endocrinology only

56.

Lifestyle medicine reverses which root driver?

a)

Genetics

b)

Behaviour

c)

Infection

d)

Autoimmunity

57.

Early diabetes shows partial reversibility of which function?

a)

Alpha cell

b)

Beta cell

c)

Delta cell

d)

Liver cell

58.

Post-meal walking reduces glucose peaks by:

a)

Ten percent

b)

Fifteen percent

c)

Twenty to thirty percent

d)

Forty percent

59.

Minimum sleep linked with increased insulin resistance:

a)

Four hours

b)

Five hours

c)

Six hours

d)

Eight hours

60.

Remission is improved most by reducing:

a)

Hepatic glucose output

b)

Platelet function

c)

Protein intake

d)

Sodium load

61.

Diet trials showing forty-six percent remission at one year:

a)

DPP

b)

Look AHEAD

c)

DIRECT

d)

Finnish DPS

62.

Most consistent guideline advice is to increase:

a)

Meat

b)

Fruits

c)

Vegetables

d)

Sugar

63.

Ultra-processed foods mainly cause:

a)

Low cortisol

b)

Inflammation

c)

Low insulin

d)

Low glucose

64.

Strongest contributor to hyperglycemia among substances:

a)

Tobacco

b)

Alcohol

c)

Sugary drinks

d)

Salt

65.

Stress increases glucose via hormone:

a)

Thyroxine

b)

Cortisol

c)

Aldosterone

d)

Progesterone

66.

Movement used as "glucose disposal therapy":

a)

Fasting

b)

Post-meal walk

c)

Yoga only

d)

Swimming only

67.

Most protective sleep target:

a)

Four hours

b)

Five hours

c)

Seven to eight hours

d)

Ten hours

68.

Strong predictor of better adherence in diabetes:

a)

Income

b)

Social support

c)

Marital status

d)

Gender

69.

Diet pattern rich in olive oil and fish:

a)

Atkin

b)

Mediterranean

c)

Mind

d)

Dash

70.

Behavioural drivers of obesity best reversed by:

a)

Surgery

b)

Medication

c)

Lifestyle

d)

Supplements

71.

Postural behaviour needing interruption every thirty minutes:

a)

Running

b)

Standing

c)

Sitting

d)

Sleeping

72.

Limiting this fat improves insulin sensitivity:

a)

Saturated fat

b)

Poly fat

c)

Mono fat

d)

Omega fat

73.

Most helpful proteins for glycemic control:

a)

Red meat

b)

Chicken

c)

Fish

d)

Cheese

74.

Sleep disruption increases:

a)

Glucose stability

b)

Glucose variability

c)

Ketone stability

d)

Appetite loss

75.

Emotional eating is strongly driven by:

a)

Low oxygen

b)

Stress

c)

Sodium

d)

Growth hormone

76.

First-line intervention in type 2 diabetes?

a)

Tablets

b)

Lifestyle

c)

Insulin

d)

Surgery

77.

Main cause of increased fasting glucose early in disease?

a)

Low insulin

b)

High glucagon

c)

High fat

d)

Low exercise

78.

Drug group that lowers risk of heart failure admission?

a)

Pioglitazone

b)

Alpha blockers

c)

SGLT2 inhibitors

d)

Sulfonylurea

79.

Drug class with weight loss benefit?

a)

DPP4 inhibitors

b)

GLP1 agonists

c)

Sulfonylurea

d)

Meglitinides

80.

Drug class linked with weight gain?

a)

Insulin

b)

GLP1 agonists

c)

SGLT2 inhibitors

d)

Metformin

81.

When to start dual therapy?

a)

A1C under six

b)

A1C under seven

c)

A1C eight point five or more

d)

A1C ten or more

82.

Drug with strong kidney protection?

a)

DPP4 inhibitors

b)

Sulfonylurea

c)

SGLT2 inhibitors

d)

Insulin

83.

Empagliflozin reduces death from heart causes by?

a)

Ten percent

b)

Twenty percent

c)

Thirty-eight percent

d)

Fifty percent

84.

Empagliflozin reduces new or worsening kidney disease by?

a)

Ten percent

b)

Twenty percent

c)

Thirty-nine percent

d)

Fifty percent

85.

Early disease stage with rising glucose post meals?

a)

Normal

b)

Prediabetes

c)

Severe diabetes

d)

Crisis

86.

A one percent fall in A1C reduces stroke risk by?

a)

Twelve percent

b)

Thirty percent

c)

Forty percent

d)

Fifty percent

87.

Cardiovascular guideline recommending risk-based drug choice?

a)

ADA

b)

EASD

c)

ESC

d)

WHO

88.

Condition strongly linked with insulin resistance?

a)

Migraine

b)

Central obesity

c)

Appendicitis

d)

Asthma

89.

Drug option for high cardiovascular risk?

a)

Sulfonylurea

b)

DPP4 inhibitors

c)

SGLT2 inhibitors

d)

Bromocriptine

90.

Therapy recommended when A1C ten or more?

a)

One tablet

b)

Dual therapy

c)

Insulin

d)

Diet only