Diabetes Patho- Endocrine Exam Quiz

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  • 1/13 Questions

    Your patient is a 12-y-o girl with type I diabetes who is going to have a surgical procedure for the removal of a foreign object in her right bronchus.  You know that she might require insulin perioperitively because: 

    • This type of diabetes results in little if any insulin secretion
    • Stress of hospitalization and surgery is likely to raise her glucose levels
    • A and B
    • Neither A or B
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About This Quiz

This quiz titled 'Diabetes Patho- Endocrine Exam' assesses knowledge on diabetes-related endocrine issues, including blood glucose management, complications, and perioperative care. It is designed for medical students and professionals to enhance understanding and clinical skills in managing diabetes.

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  • 2. 

    Your patient is a 87-y-o nursing home resident and passed out today in her room.  She hit her head and is going to the OR for an evacuation of a subdural hematoma.  She has diabetes, HTN, and hyperlipidemia.   Her labs reveal:pH 7.32Glucose 805HCO3 21Serum Osmolarity 376The nursing home tech reports that the patient has not been eating or drink much for 2 weeks.  You suspect: 

    • She has HHS

    • She will need significant fluid resuscitation

    • A and B

    • Neither A or B

    Correct Answer
    A. A and B
    Explanation
    The patient's high glucose level (805) and the fact that she has not been eating or drinking much for 2 weeks suggest that she has hyperosmolar hyperglycemic state (HHS). HHS is a serious condition characterized by extremely high blood glucose levels and severe dehydration. The patient will require significant fluid resuscitation to correct the dehydration and stabilize her condition. Therefore, both options A and B are correct.

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  • 3. 

    All of the following are common sites of insulin resistance in Type II diabetes, EXCEPT: 

    • Skeletal Muscle

    • Brain

    • Adipose Tissue

    • LIver

    Correct Answer
    A. Brain
    Explanation
    Insulin resistance is a condition where the body's cells become less responsive to insulin, leading to elevated blood sugar levels. In Type II diabetes, insulin resistance commonly occurs in skeletal muscle, adipose tissue, and the liver. However, the brain is not typically considered a site of insulin resistance in Type II diabetes. Insulin plays a crucial role in regulating glucose uptake in skeletal muscle, adipose tissue, and the liver, but its role in the brain is more related to appetite regulation and cognitive function.

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  • 4. 

    Using the same patient from the last question, what would be the most important factor for the development of ESRD with diabetes 

    • HTN

    • Decreased GI Motility

    • Dyslipidemia

    Correct Answer
    A. HTN
    Explanation
    Hypertension (HTN) is the most important factor for the development of End-Stage Renal Disease (ESRD) with diabetes. Uncontrolled high blood pressure can damage the blood vessels in the kidneys, leading to kidney damage and eventually ESRD. Diabetes already puts the kidneys at risk, and when combined with HTN, the risk is further increased. Therefore, managing and controlling hypertension is crucial in preventing the development and progression of ESRD in patients with diabetes.

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  • 5. 

    Which of the following produce an increase in blood glucose levels? 

    • Glucagon

    • Epinephrine

    • Lactic Acid

    • Ketones

    • Growth Hormone

    • Cortisol

    • A, B, & C

    • A, B, E, & F

    Correct Answer
    A. A, B, E, & F
    Explanation
    Glucagon, epinephrine, growth hormone, and cortisol all contribute to an increase in blood glucose levels. Glucagon stimulates the liver to release glucose into the bloodstream, while epinephrine stimulates the breakdown of glycogen into glucose. Growth hormone and cortisol also promote glucose production by the liver. Lactic acid and ketones, on the other hand, do not directly increase blood glucose levels. Lactic acid is produced during anaerobic exercise and ketones are produced during periods of fasting or when the body is breaking down fat for energy.

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  • 6. 

    Your patient is a 46-y-o male with type II diabetes who is going to the cath lab for a diagnostic cath post several episodes of chest pain.  He is very anxious, so a request for an anesthesia provider was made by the interventional cardiologist.  Which of the following is the greatest contributing factor for the development of atherosclerosis secondary to diabetes? 

    • HTN

    • ESRD

    • Dyslipidemia

    Correct Answer
    A. Dyslipidemia
    Explanation
    Dyslipidemia is the greatest contributing factor for the development of atherosclerosis secondary to diabetes. Diabetes is known to cause abnormal lipid metabolism, leading to elevated levels of LDL cholesterol and triglycerides, and decreased levels of HDL cholesterol. These lipid abnormalities contribute to the formation of atherosclerotic plaques in the arteries, increasing the risk of cardiovascular complications. HTN (hypertension) and ESRD (end-stage renal disease) are also common complications of diabetes, but they are not the primary factors responsible for the development of atherosclerosis in this case.

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  • 7. 

    When reviewing your patient's H&P you note that he has Type I DM, Peripheral neuropathy, and HTN. You know: 

    • Sensory deficits in peripheral neuropathy progress as "stocking glove"

    • Sensory deficits overshadow motor deficits

    • A & B

    • Neither A or B

    Correct Answer
    A. A & B
    Explanation
    The correct answer is A & B. This is because sensory deficits in peripheral neuropathy do progress as "stocking glove," meaning that they start in the feet and progress up the legs and hands. Additionally, sensory deficits in peripheral neuropathy tend to overshadow motor deficits, meaning that the loss of sensation is more prominent than any loss of motor function.

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  • 8. 

    Your patient with a history of Type II diabetes, HTN, and renal insufficiency is having an emergent AAA repair.  His wife tells you he has Diabetic Autonomic Neuropathy.  You are concerned because you know DAN causes risks related to: 

    • Gastroparesis

    • Impaired barorecptor function

    • A & B

    • Neither A nor B

    Correct Answer
    A. A & B
    Explanation
    Diabetic Autonomic Neuropathy (DAN) is a complication of diabetes that affects the autonomic nervous system. This can lead to various complications, including gastroparesis (delayed stomach emptying) and impaired baroreceptor function. Gastroparesis can cause symptoms such as nausea, vomiting, and bloating, while impaired baroreceptor function can result in abnormal regulation of blood pressure. Therefore, both options A and B are correct as they describe risks related to DAN.

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  • 9. 

    In what patient would you expect to see a positive result for an ICA? 

    • Type I diabetic

    • Type II diabetic

    • Type II diabetic treated with insulin and not oral hypoglycemics

    Correct Answer
    A. Type I diabetic
    Explanation
    A positive result for an ICA (Islet Cell Antibody) would be expected in a Type I diabetic patient. Type I diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Islet Cell Antibodies are autoantibodies that target the islet cells of the pancreas. Therefore, it is likely that a Type I diabetic patient would have a positive result for an ICA test.

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  • 10. 

    Your patient is a well controlled diabetic with HTN.  His home meds include: NSAID for neuropathic pain (which he has not taken in the last 2 weeks) Metoprolol and Glipizide.  Your peroperative medication instructions include:

    • Take metoprolol as usual

    • Do not take glipizide for at least 24 hrs pre-op

    • A & B

    • Neither A or B

    Correct Answer
    A. A & B
    Explanation
    The patient is a well-controlled diabetic with hypertension and is taking NSAID for neuropathic pain, Metoprolol, and Glipizide. The peroperative medication instructions state to take Metoprolol as usual and to not take Glipizide for at least 24 hours pre-op. The correct answer, A & B, means that both instructions A and B should be followed. Therefore, the patient should continue taking Metoprolol as usual and should not take Glipizide for at least 24 hours before the surgery.

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  • 11. 

    Your patient is a 15-y-o female who has had flu-like symptoms for the past 2 days.  She has diabetes and her mother reports has not been taking her insulin because she has not been eating.  Her Chem 10 panal shows the following results:Glucose 378HCO3: Unable to be calculated (your lab report says this means <5)Anion gap: Unable to calculate K+ 4.0 Your patient need an emergent removal of her appendix. You suspect she has DKA and want to include all of the following in your plan of care, EXCEPT:

    • Give large volumes of NS

    • Give Insulin

    • Give Potassium

    • Ensure Na+ levels do not rise as hyperglycemia is being corrected

    • Monitor CBGs very closely during the case

    Correct Answer
    A. Ensure Na+ levels do not rise as hyperglycemia is being corrected
    Explanation
    In a patient with diabetic ketoacidosis (DKA), there is a deficiency of insulin leading to high blood glucose levels. This causes the body to break down fat for energy, resulting in the production of ketones. DKA is a medical emergency that requires prompt treatment. The correct answer is "Ensure Na+ levels do not rise as hyperglycemia is being corrected" because in DKA, there is typically a deficit of total body sodium due to osmotic diuresis. Therefore, it is important to monitor and correct any electrolyte imbalances, including sodium, during the treatment of DKA.

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  • 12. 

    Your patient is a 67-y--o male who weighs 150kg and is having a hip replacement.   Your preoperative Chem 10 notes a glucose of 155 mg d/L.  He confirms having been NPO since last night.  He asks you if he has diabetes and if you will have to cancel his surgery.  You base your answer on your knowledge that type II diabetes: 

    • Has a slow progression and there are often abnormalities years before diagnosis

    • All surgical procedures should be cancelled for a CBG > 150 mg d/L

    • A & B

    • A nor B

    Correct Answer
    A. Has a slow progression and there are often abnormalities years before diagnosis
    Explanation
    Type II diabetes has a slow progression and there are often abnormalities years before diagnosis. This means that the patient may have had diabetes for a long time before it was actually diagnosed. In this case, the patient's high glucose level of 155 mg d/L suggests that he may have diabetes. However, it does not necessarily mean that his surgery needs to be cancelled. The decision to cancel surgery would depend on various factors and would be made by the healthcare provider in consultation with the patient.

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  • 13. 

    When formulating a plan of care for your patient with diabetes, you expect to consider all of the following, EXCEPT:

    • Difficult intubation

    • Increased gastric content

    • Checking CBG Q 1 hr

    • Maintaining CBG between 80 - 100 mg d/L

    Correct Answer
    A. Maintaining CBG between 80 - 100 mg d/L
    Explanation
    When formulating a plan of care for a patient with diabetes, it is important to consider various factors. Difficult intubation may be a concern for patients with diabetes, as they may have coexisting conditions that can affect airway management. Increased gastric content is another consideration, as patients with diabetes may have delayed gastric emptying, which can impact medication absorption and timing of meals. Checking CBG (capillary blood glucose) every 1 hour is also important to monitor blood sugar levels and adjust treatment accordingly. However, maintaining CBG between 80-100 mg/dL is not a consideration, as this is the desired target range for blood sugar control in diabetes.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 12, 2011
    Quiz Created by
    Smmedina
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