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Test Your Knowledge

Take a quiz and test your knowledge on diabetes and related health concerns.

Question #821

Test Your Knowledge

Mr. Hernandez is an overweight (BMI 30 kg/m2), 45-year-old plumber of Hispanic heritage who arrives at your office for a first-time visit. He has not been to a physician during the last 7 years because he hasn’t always had health insurance and “doesn’t like going to the doctor.” However, he has been noticing lately that his vision seems a little blurry and he’s developed a red, itchy rash in his groin. He is a non-smoker and recalls being told a long time ago that he should eat a low salt diet, but he can’t remember why. On examination, his BP is 154/96 mm/Hg, and his pulse is 72, RR 22. His physical exam is notable for signs of a yeast infection in his groin. You order a CBC, Chem 12 panel and A1C to be drawn that day before he leaves. You advise him how to treat his skin infection. When you receive the results of the Chem 12 panel, it shows a random plasma glucose of 162 mg/dL. His A1C was 7.3%. You call Mr. Hernandez and ask him to return the next morning, before he has eaten, for additional labs. In this individual, you might order all the following labs EXCEPT urine ketones. Mr. Hernandez labs return and are notable for A1C 7.5, FPG 137 mg/dL, LDL-cholesterol 190 mg/dL, HDL-cholesterol 38 mg/dL and triglycerides 232 mg/dL. You discuss his lab results, his diagnosis and how to manage diabetes, and make referrals to the appropriate diabetes team clinicians. You start Mr. Hernandez on metformin, lifestyle modifications, an ACE inhibitor and a statin. What glycemic and blood pressure parameters are you looking to achieve for most individuals? A. A1C<7%, BP<130/80 mmHg B. A1C<7%, BP<130/90 mmHg C. A1C<7%, BP<140/80 mmHg D. A1C<7%, BP<140/90 mmHg Follow the link to respond!

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Question #820

Test Your Knowledge

Mr. Hernandez is an overweight (BMI 30 kg/m2), 45-year old plumber of Hispanic heritage who arrives at your office for a first-time visit. He has not been to a physician during the last 7 years because he hasn’t always had health insurance and “doesn’t like going to the doctor.” However, he has been noticing lately that his vision seems a little blurry and he’s developed a red, itchy rash in his groin. He is a non-smoker and recalls being told a long time ago that he should eat a low salt diet, but he can’t remember why. On examination, his BP is 154/96 mm/Hg, and his pulse is 72, RR 22. His physical exam is notable for signs of a yeast infection in his groin. You order a CBC and A1C to be drawn that day before he leaves. You advise him how to treat his skin infection. When you receive the results of the chem 12 panel, it shows a random plasma glucose of 162 mg/dL and A1C 7.3%. You call Mr. Hernandez and ask him to return the next morning, before he has eaten, for additional labs. In this individual, you might order all the following labs EXCEPT...follow the link to select your answer!

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Question #819

(Continued from Question #816, Question #817 and Question #818 ) Mrs. O’Doole is a 34-year-old of Irish descent. She works as a florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees to be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her that while only mildly elevated, she has impaired fasting glucose. She was started on lifestyle modifications plus dietary modifications, and exercise for weight loss. At a follow-up appointment 6 months later, Mrs. O’Doole tells you despite good intentions, she has not been able to adhere to any meaningful lifestyle changes, in fact she has gained 5 pounds. At this time, her repeat fasting plasma glucose shows FPG 138 mg/dL. After discussing management options with her, you decide the best management would be metformin and lifestyle modifications. You discuss the benefits of lifestyle changes with Mrs. O’Doole and tell her that you are referring her to an exercise program specifically for individuals with type 2 diabetes. What schedule of exercise is recommended for patients like Mrs. O’Doole? Follow the link to answer!

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Question #818

(Continued from Question #816 and Question #817) Mrs. O’Doole is a 34-year-old of Irish descent. She works as a florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her that, while only mildly elevated, she has impaired fasting glucose. She was started on lifestyle modifications plus dietary modifications, and exercise for weight loss. At a follow-up appointment 6 months later, Mrs. O’Doole tells you, despite good intentions, she has not been able to adhere to any meaningful lifestyle changes; in fact she has gained 5 pounds. At this time her repeat fasting plasma glucose shows FPG 138 mg/dL. After discussing management options with her, you decide the best management would be: (follow the link to respond!)

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Question #817

Mrs. O’Doole is a 34-year-old of Irish descent. She works as a florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her that, while only mildly elevated, she has impaired fasting glucose. What is the best choice for initial management of Mrs. O’Doole’s prediabetes? Follow the link to respond.

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Question #816

Mrs. O’Doole is a 34-year-old of Irish descent. She works as florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. What clinical diagnosis would suggest screening Mrs. O'Doole for type 2 diabetes? Follow the link to answer.

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Question 815

Test Your Knowledge

A patient that you haven’t seen for several years comes to your clinic for a wellness check-up. Since her last visit, she has gained about 15 pounds (5’6”, BMI 27 kg/m2). Her stage 1 hypertension is controlled with hydrochlorothiazide. As you discuss her weight gain, you learn that she doesn’t get more than 30 minutes a week of physical activity. You decide it would be best to check her A1C. Which of the following information from her history leads you to screen her for type 2 diabetes? Follow the link to respond.

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Question #814

Test Your Knowledge

You are reviewing lifestyle modifications with a 42-year-old, relatively sedentary patient who has been newly diagnosed with prediabetes. Your screening for any cardiovascular risk factors was negative, so she has agreed to a 3-month trial of dietary modifications and increased physical activity. Structured exercise interventions and modest weight loss have been shown to lower the risk of developing type 2 diabetes in high-risk populations by an average of: (follow link to answer!)

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Question #812

Test Your Knowledge

A 59-year-old patient who was diagnosed with type 2 diabetes five years ago presents to your clinic for an appointment. He has a history of hypertension and dyslipidemia, both currently well controlled with medication. He has been taking metformin and a DPP-4 inhibitor. He tells you he is concerned about a sore on his foot that is taking a long time to heal. At today’s visit, his office A1C is 8.8%. After discussing his options, you decide to add basal insulin analogue detemir to his regimen. Compared to insulin NPH, what would you expect him to experience while taking detemir? Follow the link to answer.

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Question #811

Test Your Knowledge

A 39-year-old, overweight (BMI 27 kg/m2) patient comes into your office for his annual wellness examine. Routine labs show random plasma glucose of 176 mg/dL, so you ask him to return for a fasting plasma glucose and A1C. The results show a FPG 139 mg/dL and A1C of 7.7%. He is resistant to the idea of starting medication and is very keen on pursuing a trial period of dietary modifications and an exercise program, especially after you tell him about the benefits of moderate exercise on diabetes. Which of the following statements about exercise is true? Follow the link to answer!

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