Saturday, October 01, 2005

N4 test Pancreas: Glucose Metabolism and Diabetes Mellitus

Price: Pathophysiology, 6th Edition
Study Questions Chapter 63: Pancreas: Glucose Metabolism and Diabetes Mellitus

1. Which of the following tests is the most sensitive in the diagnosis of diabetes mellitus?
A. Fasting plasma glucose
B. 2-hour postprandial plasma glucose
C. Standard oral glucose tolerance

2. The purpose of the 2-hour postprandial plasma glucose test is to:
A. Assess the ability of an individual to dispose of a glucose load
B. Test the insulin-secreting capacity of the islets of Langerhans under stress
C. Determine insulin requirements
D. Detect gestational diabetes

3. The major defect in diabetes mellitus is a disorder in the secretion of:
A. Epinephrine
B. Cortisol
C. Insulin
D. Decreased growth hormone production

4. The prevalence rate of diabetes mellitus is calculated at a minimum of how many million cases in the United States?
A. 1
B. 3
C. 6
D. 16

5. Robert M., a 30-year-old man, is being treated in an outpatient clinic. His history reveals that he has a bilateral family history of diabetes mellitus. His 2-hour postprandial blood glucose test shows levels of 115 mg/dl. Robert would most probably be classified as having:
A. Type 1 diabetes
B. Secondary diabetes
C. Type 2 diabetes
D. Impaired glucose tolerance

6. The individual with type 1 diabetes usually has all the following except:
A. Weight gain
B. Polydipsia
C. Polyuria
D. Fatigue
E. Polyphagia

7. Jane S., 10 years old, is admitted to the hospital and diagnosed as having type 1 diabetes. The medical management that would most likely be prescribed for Jane is:
A. A fixed amount of carbohydrate, fat, and protein distributed throughout the day plus an oral hypoglycemic agent
B. A meal plan plus insulin therapy
C. Education about diabetes and oral hypoglycemic agents

8. If a patient with diabetes is given an excessive dose of NPH insulin at 7 am, when would one expect to see a hypoglycemic reaction (if such a reaction occurs)?
A. Within ½ hour
B. 11 am
C. 4 pm
D. Midnight

9. The most common metabolic complication of insulin therapy is:
A. Hypoglycemia
B. Hyperglycemia
C. Ketoacidosis
D. Diabetic coma

10. Glucagon is used primarily to treat the patient with:
A. Diabetic ketoacidosis (DKA)
B. Hyperglycemic, hyperosmolar, nonketotic coma (HHNK)
C. Insulin-induced hypoglycemia
D. Hypokalemia

11. The diagnosis of hypoglycemic coma in an unconscious patient is best established by which of the following?
A. Cerebrospinal fluid glucose of 45 mg/dl or less
B. Blood glucose of 45 mg/dl or less and serum insulin of 100 mU/ml
C. Blood glucose of 45 mg/dl or less with reversal of coma after rapid intravenous glucose administration
D. An electroencephalogram showing slow delta waves

12. It is important to treat hypoglycemia promptly in a diabetic patient to prevent:
A. Depletion of liver glycogen
B. Permanent brain damage
C. Peripheral neuropathy
D. Retinopathy
E. Weight loss

13. The primary difference between DKA and HHNK is:
A. The level of hyperosmolality
B. The level of hyperglycemia
C. The amount of extracellular fluid volume depletion
D. The amount of ketones produced

14. The chronic effect of diabetes on the nervous system is mainly a result of:
A. Collapse of the vertebrae
B. Increased incidence of seizures
C. Peripheral neuropathy
D. Degeneration of the anterior horn cells

15. A level of glycated hemoglobin indicating good control of hyperglycemia in a diabetic patient would be:
A. 10% or more
B. 8%
C. 6% to 8%
D. Less than 6%

16. Glucose is removed from the bloodstream by: (More than one answer may be correct.)
A. Conversion to glycogen by the liver
B. Peripheral glucose use by muscle or adipose tissue

17.Fasting hypoglycemia will usually occur when there is: (More than one answer may be correct.)
A. Pancreatic islet cell tumor
B. Cirrhosis of the liver when the patient is unable to synthesize glycogen
C. Excessive production of cortisol
D. Excessive production of growth hormone

18.Current theories of the pathogenesis of diabetes mellitus include: (More than one answer may be correct.)
A. Autoimmune destruction of beta cells
B. Viral destruction of beta cells
C. Genetically determined defects in insulin release
D. Decreased growth hormone production

19. Which of the following are the usual characteristics of a type 2 diabetes patient? (More than one answer may be correct.)
A. Relative insensitivity to insulin
B. Obesity
C. Very low islet cell reserve
D. Proneness to diabetic ketoacidosis

20. Complications of diabetes mellitus include which of the following? (More than one answer may be correct.)
A. Peripheral vascular insufficiency
B. Diabetic nephropathy
C. Ketoacidosis
D. Retinopathy

21. Type 1 diabetes is characterized by which of the following? (More than one answer may be correct.)
A. Genetically determined autoimmune disease
B. Anti-islet cell antibodies present in the initial stage of the disease
C. Strong familial pattern of occurrence
D. Defect in secretion as well as in insulin action

22. Glucagon can best be described as a hormone that is: (More than one answer may be correct.)
A. Secreted by the pancreatic alpha cells
B. Effective in raising blood glucose levels
C. Important in preventing hypoglycemia during the fasting state
D. Important in preventing glycosuria
E. Synergistic in its actions with insulin

23. Central nervous system manifestations related to inadequate glucose for metabolism by the brain include: (More than one answer may be correct.)
A. Bizarre behavior
B. Seizures
C. Coma
D. Hypothermia

24. Untreated hyperglycemia in a patient with type 1 diabetes results in: (More than one answer may be correct.)
A. Metabolic alkalosis
B. Metabolic acidosis
C. Increasing lethargy → coma
D. Respiratory acidosis
E. Osmotic diuresis and dehydration

25. Which of the following statements concerning intensive insulin therapy for diabetes (use of an external insulin pump or multidose insulin injections guided by frequent blood glucose monitoring) is correct? (More than one answer may be correct.)
A. The DCCT study definitely showed that intensive insulin therapy reduced the likelihood of retinopathy, nephropathy, and neuropathy in patients with type 1 diabetes compared with standard therapy.
B. Intensive insulin therapy failed to reduce the level of glycated hemoglobin.
C. All patients with diabetes mellitus should receive such therapy.
D. Hypoglycemia is a more frequent complication than with the standard therapy.

26. Heart attacks occur at least 2½ times as often in patients with diabetes as in normal individuals of comparable age.
True False

27. Twenty-five percent of all patients with diabetes eventually die of vascular disease, heart attacks, kidney failure, strokes, or gangrene.
True False

28. Exercise tends to increase blood sugar by blocking transport of glucose into the tissues.
True False

29. Obesity is a frequent finding in patients with type 2 diabetes.
True False

1 comment:

Bonnie Boss said...

1c, 2a, 3c, 4d, 5d, 6a, 7b, 8c, 9a, 10c, 11c, 12b, 13d, 14c, 15d 16ab, 17ab, 18abc, 19ab, 20abcd, 21ab, 22abc, 24bce, 25ad, 26T, 27F 75%, 28F, 29T