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Test Your Knowledge

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

Treatment Changes

Test Your Knowledge

A 42-year-old patient was diagnosed with type 2 diabetes approximately one year ago and is currently taking metformin, a DPP-4 inhibitor, and a basal insulin dose (current daily dose .9 U/kg/day). Despite good compliance with her diet, exercise, and medication regimen, she reports postprandial glucose measurements of usually about 190 mg/dL. Her current A1C is 7.6%. Which of the following changes in her management do you consider most important? A. Add a sulfonylurea to her regimen B. Increase her basal insulin dose C. Add a pre-meal rapid-acting insulin D. Discontinue her basal insulin dose and add a prandial insulin dose Follow the link to see the answer.

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Impaired Renal Function

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At her last visit, your patient’s labs showed a eGFR 55 ml/min/1.73 m2. At this visit, her labs measured an eGFR of 44 ml/min/1.73 m2. Dose reduction/cessation should be considered for all of the following agents EXCEPT: A. Glyburide B. Sitaglipitin C. Metformin D. Pioglitazone Follow the link for the correct answer.

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Acanthosis nigricans

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Acanthosis nigricans presents as a brown to black pigmentation usually seen in the neck or armpit areas. In relation to diabetes, this may indicate: A) granuloma annulare B) diabetic dermopathy C) type 1 diabetes D) insulin resistance Follow the link to see the correct answer.

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Minimizing Side Effects

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Your patient has been newly diagnosed with type 2 diabetes (A1C 7.7%) and you have prescribed metformin. Metformin should be titrated to minimize which side effect? A. Rebound hyperglycemia B. Reactive hypoglycemia C. Weight gain D. Gastrointestinal-side effects Follow the link to see the answer.

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GLP-1 Contraindications

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Which of the following are strict or relative contraindications to the use of some of the GLP-1 agonists? A. Multiple endocrine neoplasia (MEN) syndrome type 2 B. Personal or family history of medullar thyroid cancer C. Pancreatitis D. All of the above Follow the link to see the right answer.

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Medication Mystery

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A 72-year-old patient arrives in your office complaining of shakiness and sweating before he went to bed the previous night. He doesn’t recall checking his blood glucose level at the time, however he felt better after a glass of milk and a few graham crackers. His current medications are metformin, pioglitazone, and glyburide. Which one of the following medications is the most likely cause of his symptoms? 1) Metformin 2) Pioglitazone 3) Glyburide Follow the link to see the right answer.

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Prandial Insulin Administration

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Your patient has been systematically titrating his basal insulin dose for the last 6 months; his daily dose is NPH .90 U/kg/day. Despite his good efforts, you decide it would be prudent to add a prandial insulin dose to his treatment regimen. Which of the following scenarios might lead you to this conclusion? A) A1C=7.4%, FPG<130 mg/dl, PPG>180 mg/dl B) A1C=7.0%, FPG<130 mg/dl, PPG<180 mg/dl C) A1C=7.0%, FPG<120mg/dl, PPG<160mg/dl D) A1C=6.8%, FPG<120 mg/dl, PPG<160 mg/dl Follow the link to see if you got it right.

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Smoking and Heart Disease

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All the following are true about smoking and heart disease EXCEPT: A. Compared with nonsmokers, the incidence of myocardial infarction (MI) is increased 6-fold in women who smoke approximately 20 cigarettes per day. B. Male smokers are 25% more likely to develop coronary heart disease than female smokers. C. Smoking cessation rapidly increases high-density lipoprotein (HDL) cholesterol. D. Smokers who take a thrombolytic agent for an acute MI have better outcomes than nonsmokers. E. All of these statements are true. Do you have the right answer? Follow the link to see.

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