ACNP Endocrine - Questions And Proper Solutions
Diabetes Type 1 Right Ans - strongly associated with presence of human
leukocyte antigens and a genetic predisposition
Diabetes Type 1 Right Ans - islet cell antibodies found in approximately
90% of patients within first year of diagnosis
Diabetes Type 1 Right Ans - ketone development usually occurs. often have
recent weight loss at time of diagnosis
Diabetes Type 1 Right Ans - believed to be the result of an infectious or
toxic environmental insult to pancreatic B cells of genetically predisposed
persons
Common Lab findings in Diabetes Right Ans - Random plasma glucose >
200
serum fasting glucose >126 on 2 separate ocassions
Ketonemia, ketonuria or both (type 1 only)
increased BUN/ Cr
increased Hgb A1c
Insulin therapy for DM1 Right Ans - Initiate with 0.5 u/kg/day, giving 2/3
of the dose in the A< and the remaining 1/3 in the evening
- Conventional: AM dose is 2/3 NPH and 1/3 Regular; PM dose is 1/2 NPH and
1/2 regular
- Intensive: reduce or omit the PM dose and add a portion at bedtime
Diabetes Type 2 Right Ans - circulating insulin exists enough to prevent
ketoacidosis, but is inadequate to meet the patient's insulin needs
Diabetes Type 2 Right Ans - caused by either tissue insensitivity to insulin
or an insulin secretory defect resulting in resistance and/or impaired insulin
production
Syndrome X Right Ans - obestiy, HTN, abnormal lipid profiles (low HDLs
and high triglycerides)
Metabolic Syndrome Right Ans - YES to any 3...
, 1. Waist circumference >40 in (101.6 cm) in men, and >35 in (88.9 cm) in
women
2. BP > 130/85
3. Triglycerides > 150
4. FBG > 100
5. HDL < 40 in men and < 50 in women
Diabetes Type 2 Right Ans - insidious onset of hyperglycemia
Diabetes Type 2 Right Ans - recurrent vaginitis is often first symptom in
women, peripheral neuropathies, blurred vision or vision changes in 1 year,
chronic skin infections including pruritus
Diabetes Type 2 Right Ans - Same labs/diagnostics as Type 1 except NO
ketones in blood or urine
Diabetes Type 2 Treatment Right Ans - Begin with weight control for
obese, dietary treatment, exercise, early use of oral antidiabetics
Sulfonylureas Right Ans - most widely prescribed
stimulate the pancreas to release more insulin
Sulfonylureas Right Ans - Glipizide, Glyburide, Glimepiride
"G" group
Biguanides Right Ans - Standard of care for DM2 diagnoses
Good adjunct but can be used alone, especially for obese patients
Increase insulin sensitivity
Metformin Right Ans - Biguanide with common side effect of lactic acidosis.
Patient may present with muscle pain.
Alpha-glucosidase inhibitors Right Ans - bind to disaccharidases more
readily than sucrose, so less glucose is absorbed by the gut
Alpha-glucosidase inhibitors Right Ans - Acarbose (Precose), Miglitol
(Glyset)
Diabetes Type 1 Right Ans - strongly associated with presence of human
leukocyte antigens and a genetic predisposition
Diabetes Type 1 Right Ans - islet cell antibodies found in approximately
90% of patients within first year of diagnosis
Diabetes Type 1 Right Ans - ketone development usually occurs. often have
recent weight loss at time of diagnosis
Diabetes Type 1 Right Ans - believed to be the result of an infectious or
toxic environmental insult to pancreatic B cells of genetically predisposed
persons
Common Lab findings in Diabetes Right Ans - Random plasma glucose >
200
serum fasting glucose >126 on 2 separate ocassions
Ketonemia, ketonuria or both (type 1 only)
increased BUN/ Cr
increased Hgb A1c
Insulin therapy for DM1 Right Ans - Initiate with 0.5 u/kg/day, giving 2/3
of the dose in the A< and the remaining 1/3 in the evening
- Conventional: AM dose is 2/3 NPH and 1/3 Regular; PM dose is 1/2 NPH and
1/2 regular
- Intensive: reduce or omit the PM dose and add a portion at bedtime
Diabetes Type 2 Right Ans - circulating insulin exists enough to prevent
ketoacidosis, but is inadequate to meet the patient's insulin needs
Diabetes Type 2 Right Ans - caused by either tissue insensitivity to insulin
or an insulin secretory defect resulting in resistance and/or impaired insulin
production
Syndrome X Right Ans - obestiy, HTN, abnormal lipid profiles (low HDLs
and high triglycerides)
Metabolic Syndrome Right Ans - YES to any 3...
, 1. Waist circumference >40 in (101.6 cm) in men, and >35 in (88.9 cm) in
women
2. BP > 130/85
3. Triglycerides > 150
4. FBG > 100
5. HDL < 40 in men and < 50 in women
Diabetes Type 2 Right Ans - insidious onset of hyperglycemia
Diabetes Type 2 Right Ans - recurrent vaginitis is often first symptom in
women, peripheral neuropathies, blurred vision or vision changes in 1 year,
chronic skin infections including pruritus
Diabetes Type 2 Right Ans - Same labs/diagnostics as Type 1 except NO
ketones in blood or urine
Diabetes Type 2 Treatment Right Ans - Begin with weight control for
obese, dietary treatment, exercise, early use of oral antidiabetics
Sulfonylureas Right Ans - most widely prescribed
stimulate the pancreas to release more insulin
Sulfonylureas Right Ans - Glipizide, Glyburide, Glimepiride
"G" group
Biguanides Right Ans - Standard of care for DM2 diagnoses
Good adjunct but can be used alone, especially for obese patients
Increase insulin sensitivity
Metformin Right Ans - Biguanide with common side effect of lactic acidosis.
Patient may present with muscle pain.
Alpha-glucosidase inhibitors Right Ans - bind to disaccharidases more
readily than sucrose, so less glucose is absorbed by the gut
Alpha-glucosidase inhibitors Right Ans - Acarbose (Precose), Miglitol
(Glyset)
