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Self-Assessment Questions


Diabetes Mellitus: Review Questions

Catherine Anastasopoulou, MD

Dr. Anastasopoulou is an endocrinologist in private practice, affiliated with Albert Einstein Medical Center and Pennsylvania Hospital, Philadelphia, PA.

Choose the single best answer for each question.

1. At his yearly physical examination, a previously healthy 55-year-old man has a fasting plasma glucose level of 130 mg/dL. Which of the following steps is most appropriate to confirm a diagnosis of diabetes mellitus?
  1. Determine the patient’s hemoglobin A1c proportion
  2. Determine the patient’s postprandial plasma glucose level
  3. Perform an oral glucose tolerance test
  4. Repeat the fasting plasma glucose test at another time
  5. Perform no further tests
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2. A man with known diabetes mellitus has a cholesterol level of 230 mg/dL, low-density lipoprotein level of 130 mg/dL, and triglyceride level of 200 mg/dL. His fasting plasma glucose level is 130 mg/dL, and his hemoglobin A1c proportion is 7.5%; he is taking glyburide 5 mg once daily. Which of the following is the next best step in treating this patient?

  1. Add metformin to his regimen
  2. Increase his dose of glyburide
  3. Recommend diet and exercise only
  4. Start administering an antilipidemic agent
  5. Switch his treatment to insulin therapy
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3. Which of the following is the most sensitive test for diagnosing diabetic nephropathy?

  1. Creatinine clearance measurement
  2. Glucose tolerance measurement
  3. Serum creatinine measurement
  4. Ultrasonography of the kidneys
  5. Urine albumin measurement
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  4. Which of the following is the counterregulatory hormone first secreted in the acute response to hypoglycemia in a patient with a recent diagnosis of diabetes mellitus?
  1. A catecholamine
  2. Cortisol
  3. Glucagon
  4. Growth hormone
  5. Somatostatin
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5. Which of the following best describes the mechanism of action of pioglitazone and rosiglitazone in treating diabetes mellitus?

  1. Decreased production of glucose by the liver
  2. Increased absorption of glucose by the intestine
  3. Increased secretion of insulin by the pancreas
  4. Increased sensitivity of peripheral tissues to insulin
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6. On physical examination, a 60-year-old African American woman with a 5-year history of diabetes mellitus has a blood pressure of 160/95 mm Hg. Renal function is mildly impaired, with a creatinine level of 1.2 mg/dL. Which of the following is the best treatment for this patient?

  1. Amlodipine administration
  2. Atenolol administration
  3. Captopril administration
  4. Furosemide administration
  5. Low-salt and low-protein diet
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