Certified Diabetes Educator Exam 2 questions |\ |\ |\ |\ |\ |\
with answers |\
Glutamic Acid Decarboxylase - CORRECT ANSWERS ✔✔A protein
|\ |\ |\ |\ |\ |\ |\ |\
that appears to be the best immunologic predictor for the future
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
development of Type 1 DM |\ |\ |\ |\
Latent Auto-Immune Diabetes of Adults - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔Slow progressive form of T1DM frequently mistaken for T2DM.
|\ |\ |\ |\ |\ |\ |\ |\
May do without insulin dependency for many years, even though
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
they have auto-immune beta-cell deterioration as Type 1's
|\ |\ |\ |\ |\ |\ |\ |\
Adipocyte - CORRECT ANSWERS ✔✔A fat cell that serves as
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
primary storage for excess calories. source of many hormones
|\ |\ |\ |\ |\ |\ |\ |\ |\
and cytokines important in controlling appetite, weight,
|\ |\ |\ |\ |\ |\ |\
inflammation and intermediary metabolism |\ |\ |\
Blood Urea Nitrogen - CORRECT ANSWERS ✔✔Blood level of urea.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Byproduct of protein metabolism. Normal Plasma value 8-20.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Level rises as kidneys deteriorate.
|\ |\ |\ |\
Creatinine - CORRECT ANSWERS ✔✔Nitrogen formed mainly from
|\ |\ |\ |\ |\ |\ |\ |\
metabolism of muscle. Normal plasma value: 0.5-1.4 mg/dl.
|\ |\ |\ |\ |\ |\ |\ |\
Varies with geneder: males have higher levels. Rises as kidney
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
function decreases but eventually will stabilize even while
|\ |\ |\ |\ |\ |\ |\ |\
kidneys go on to fail. |\ |\ |\ |\
,Ketosis - CORRECT ANSWERS ✔✔ketones produced during DKA,
|\ |\ |\ |\ |\ |\ |\ |\
one of these (acetoacetate) converts to acetone and is excreted
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
by the lungs. Fruit smell can be detected on the breath.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Acidosis - CORRECT ANSWERS ✔✔Very deep and sometimes|\ |\ |\ |\ |\ |\ |\ |\
rapid breathing unrelated to exertion or the inability to "catch"
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
one's breath is symptom call "Kussmauls Respirations"
|\ |\ |\ |\ |\ |\ |\
(hyperventilation)
DKA - CORRECT ANSWERS ✔✔occurs when there is so little
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
insulin available to transport glucose into cells that it
|\ |\ |\ |\ |\ |\ |\ |\ |\
accumulates in the blood, raising levels to 250 mg/dL or higher |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(mean 475 mg/dL). Can evolve quickly (within 24 hours) causing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dehydration, ketosis, electrolyte imbalance and acidosis. |\ |\ |\ |\ |\
DKA Electrolyte imbalance - CORRECT ANSWERS ✔✔Na, K, PO4
|\ |\ |\ |\ |\ |\ |\ |\
Sodium DKA Electrolyte Imbalances - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔dehydration caues profound loss of total body sodium that |\ |\ |\ |\ |\ |\ |\ |\ |\
cannot be measured |\ |\
K DKA imbalance - CORRECT ANSWERS ✔✔total body depletion of
|\ |\ |\ |\ |\ |\ |\ |\ |\
K alwasy w/ DKA, but lab values can be iffy. K may be low before
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
therapy or fall as it enters cells (glucose and fluid reducing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
serum concentration check renal function prior to k replacement
|\ |\ |\ |\ |\ |\ |\ |\
Phos DKA imbalance - CORRECT ANSWERS ✔✔usually high or
|\ |\ |\ |\ |\ |\ |\ |\ |\
high/normal than decreases |\ |\
,DKA therapy Providing Glucose - CORRECT ANSWERS ✔✔When
|\ |\ |\ |\ |\ |\ |\ |\
glucose lowers to 250 mg/dL, 5-10% dextrose is added to IV
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
solution. Starvation perpetuates ketosis. Also sudden drops in
|\ |\ |\ |\ |\ |\ |\ |\
glucose can be associated with cerebral edema
|\ |\ |\ |\ |\ |\
Glycogen - CORRECT ANSWERS ✔✔a complex carbohydrate that
|\ |\ |\ |\ |\ |\ |\ |\
serves as the primary storage form of glucose in the liver and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
muscle.
Gluconeogenesis - CORRECT ANSWERS ✔✔process of glucose |\ |\ |\ |\ |\ |\ |\
production in the liver from precursors, such as lactate and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
amino acids |\
hormones and factors influencing fuel metabolism ** - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔Peptide YY reduces food intake via receptors in
|\ |\ |\ |\ |\ |\ |\ |\ |\
brain. Endocannabinoid system physiological regulation of energy
|\ |\ |\ |\ |\ |\
balance, food intake lipid and glucose metabolism.
|\ |\ |\ |\ |\ |\ |\ |\
Overactivation=obesity.
Incretin hormones - CORRECT ANSWERS ✔✔Incretin hormones
|\ |\ |\ |\ |\ |\ |\
(intestinal); GIP; GLP |\ |\
GIP - CORRECT ANSWERS ✔✔glucoxe dependant insulin releasing
|\ |\ |\ |\ |\ |\ |\
polypeptide;Make beta-cells more sensitive to higher BS: Incretin
|\ |\ |\ |\ |\ |\ |\ |\
Hormone
|\
GLP - CORRECT ANSWERS ✔✔Glucagon like peptide. Make beta-
|\ |\ |\ |\ |\ |\ |\ |\
cells more sensitive to higher BS; incretin hormones
|\ |\ |\ |\ |\ |\ |\
, glucagon - CORRECT ANSWERS ✔✔Hormone produced by the
|\ |\ |\ |\ |\ |\ |\ |\
alpha cells of islets of Langerhans and a counterregulatory
|\ |\ |\ |\ |\ |\ |\ |\ |\
hormone to insulin. Glucagon release results in an increase in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
circulating glucose level by stimulating gluconeogenesis.
|\ |\ |\ |\ |\
Amylin - CORRECT ANSWERS ✔✔Secreted by beta-cells and
|\ |\ |\ |\ |\ |\ |\ |\
insulin in response to nutrient stimuli. In post prandial period,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
may mediate part of its effects by slowing of gastric empyting
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and by suppressing glucagon secretion, thus lowering hepatic
|\ |\ |\ |\ |\ |\ |\ |\
glucose production. |\
Amylin Hormone - CORRECT ANSWERS ✔✔Amylin is secreted in
|\ |\ |\ |\ |\ |\ |\ |\ |\
response to nutrient stimuli. Lowers postprandial glucose release,
|\ |\ |\ |\ |\ |\ |\
regulates gastric emptying, may suppress appetite
|\ |\ |\ |\ |\ |\
HHS - CORRECT ANSWERS ✔✔Hyperosmolar Hyperglycemic
|\ |\ |\ |\ |\ |\
State. High BS and dehydration exacerbate each other until it
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
becomes extreme. BS can get over 600 mgl/dL, but few if any
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ketones. Primarily in undiagnosed or elderly Type 2's. More life
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
threatening than DKA. |\ |\
HHS Primary Markers - CORRECT ANSWERS ✔✔*Sever
|\ |\ |\ |\ |\ |\ |\
hyperglycemia - BS >600. *Profound dehydration, plasma |\ |\ |\ |\ |\ |\ |\
osmolality >320 Osm/kg. *Neurological Changes - decreased
|\ |\ |\ |\ |\ |\ |\
mentation due to dehydration. S/S could mimic CVA. Absences of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
significant ketosis - not present in signficant amounts. GI
|\ |\ |\ |\ |\ |\ |\ |\ |\
symptoms mild. |\
A1C as Diagnostic Tool - CORRECT ANSWERS ✔✔Pts at risk >
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
5.7% -6.4%; Diabetic >6.5% & repeat test. Normal <5.7%
|\ |\ |\ |\ |\ |\ |\ |\
with answers |\
Glutamic Acid Decarboxylase - CORRECT ANSWERS ✔✔A protein
|\ |\ |\ |\ |\ |\ |\ |\
that appears to be the best immunologic predictor for the future
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
development of Type 1 DM |\ |\ |\ |\
Latent Auto-Immune Diabetes of Adults - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔Slow progressive form of T1DM frequently mistaken for T2DM.
|\ |\ |\ |\ |\ |\ |\ |\
May do without insulin dependency for many years, even though
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
they have auto-immune beta-cell deterioration as Type 1's
|\ |\ |\ |\ |\ |\ |\ |\
Adipocyte - CORRECT ANSWERS ✔✔A fat cell that serves as
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
primary storage for excess calories. source of many hormones
|\ |\ |\ |\ |\ |\ |\ |\ |\
and cytokines important in controlling appetite, weight,
|\ |\ |\ |\ |\ |\ |\
inflammation and intermediary metabolism |\ |\ |\
Blood Urea Nitrogen - CORRECT ANSWERS ✔✔Blood level of urea.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Byproduct of protein metabolism. Normal Plasma value 8-20.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Level rises as kidneys deteriorate.
|\ |\ |\ |\
Creatinine - CORRECT ANSWERS ✔✔Nitrogen formed mainly from
|\ |\ |\ |\ |\ |\ |\ |\
metabolism of muscle. Normal plasma value: 0.5-1.4 mg/dl.
|\ |\ |\ |\ |\ |\ |\ |\
Varies with geneder: males have higher levels. Rises as kidney
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
function decreases but eventually will stabilize even while
|\ |\ |\ |\ |\ |\ |\ |\
kidneys go on to fail. |\ |\ |\ |\
,Ketosis - CORRECT ANSWERS ✔✔ketones produced during DKA,
|\ |\ |\ |\ |\ |\ |\ |\
one of these (acetoacetate) converts to acetone and is excreted
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
by the lungs. Fruit smell can be detected on the breath.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Acidosis - CORRECT ANSWERS ✔✔Very deep and sometimes|\ |\ |\ |\ |\ |\ |\ |\
rapid breathing unrelated to exertion or the inability to "catch"
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
one's breath is symptom call "Kussmauls Respirations"
|\ |\ |\ |\ |\ |\ |\
(hyperventilation)
DKA - CORRECT ANSWERS ✔✔occurs when there is so little
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
insulin available to transport glucose into cells that it
|\ |\ |\ |\ |\ |\ |\ |\ |\
accumulates in the blood, raising levels to 250 mg/dL or higher |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(mean 475 mg/dL). Can evolve quickly (within 24 hours) causing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dehydration, ketosis, electrolyte imbalance and acidosis. |\ |\ |\ |\ |\
DKA Electrolyte imbalance - CORRECT ANSWERS ✔✔Na, K, PO4
|\ |\ |\ |\ |\ |\ |\ |\
Sodium DKA Electrolyte Imbalances - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔dehydration caues profound loss of total body sodium that |\ |\ |\ |\ |\ |\ |\ |\ |\
cannot be measured |\ |\
K DKA imbalance - CORRECT ANSWERS ✔✔total body depletion of
|\ |\ |\ |\ |\ |\ |\ |\ |\
K alwasy w/ DKA, but lab values can be iffy. K may be low before
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
therapy or fall as it enters cells (glucose and fluid reducing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
serum concentration check renal function prior to k replacement
|\ |\ |\ |\ |\ |\ |\ |\
Phos DKA imbalance - CORRECT ANSWERS ✔✔usually high or
|\ |\ |\ |\ |\ |\ |\ |\ |\
high/normal than decreases |\ |\
,DKA therapy Providing Glucose - CORRECT ANSWERS ✔✔When
|\ |\ |\ |\ |\ |\ |\ |\
glucose lowers to 250 mg/dL, 5-10% dextrose is added to IV
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
solution. Starvation perpetuates ketosis. Also sudden drops in
|\ |\ |\ |\ |\ |\ |\ |\
glucose can be associated with cerebral edema
|\ |\ |\ |\ |\ |\
Glycogen - CORRECT ANSWERS ✔✔a complex carbohydrate that
|\ |\ |\ |\ |\ |\ |\ |\
serves as the primary storage form of glucose in the liver and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
muscle.
Gluconeogenesis - CORRECT ANSWERS ✔✔process of glucose |\ |\ |\ |\ |\ |\ |\
production in the liver from precursors, such as lactate and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
amino acids |\
hormones and factors influencing fuel metabolism ** - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔Peptide YY reduces food intake via receptors in
|\ |\ |\ |\ |\ |\ |\ |\ |\
brain. Endocannabinoid system physiological regulation of energy
|\ |\ |\ |\ |\ |\
balance, food intake lipid and glucose metabolism.
|\ |\ |\ |\ |\ |\ |\ |\
Overactivation=obesity.
Incretin hormones - CORRECT ANSWERS ✔✔Incretin hormones
|\ |\ |\ |\ |\ |\ |\
(intestinal); GIP; GLP |\ |\
GIP - CORRECT ANSWERS ✔✔glucoxe dependant insulin releasing
|\ |\ |\ |\ |\ |\ |\
polypeptide;Make beta-cells more sensitive to higher BS: Incretin
|\ |\ |\ |\ |\ |\ |\ |\
Hormone
|\
GLP - CORRECT ANSWERS ✔✔Glucagon like peptide. Make beta-
|\ |\ |\ |\ |\ |\ |\ |\
cells more sensitive to higher BS; incretin hormones
|\ |\ |\ |\ |\ |\ |\
, glucagon - CORRECT ANSWERS ✔✔Hormone produced by the
|\ |\ |\ |\ |\ |\ |\ |\
alpha cells of islets of Langerhans and a counterregulatory
|\ |\ |\ |\ |\ |\ |\ |\ |\
hormone to insulin. Glucagon release results in an increase in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
circulating glucose level by stimulating gluconeogenesis.
|\ |\ |\ |\ |\
Amylin - CORRECT ANSWERS ✔✔Secreted by beta-cells and
|\ |\ |\ |\ |\ |\ |\ |\
insulin in response to nutrient stimuli. In post prandial period,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
may mediate part of its effects by slowing of gastric empyting
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and by suppressing glucagon secretion, thus lowering hepatic
|\ |\ |\ |\ |\ |\ |\ |\
glucose production. |\
Amylin Hormone - CORRECT ANSWERS ✔✔Amylin is secreted in
|\ |\ |\ |\ |\ |\ |\ |\ |\
response to nutrient stimuli. Lowers postprandial glucose release,
|\ |\ |\ |\ |\ |\ |\
regulates gastric emptying, may suppress appetite
|\ |\ |\ |\ |\ |\
HHS - CORRECT ANSWERS ✔✔Hyperosmolar Hyperglycemic
|\ |\ |\ |\ |\ |\
State. High BS and dehydration exacerbate each other until it
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
becomes extreme. BS can get over 600 mgl/dL, but few if any
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ketones. Primarily in undiagnosed or elderly Type 2's. More life
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
threatening than DKA. |\ |\
HHS Primary Markers - CORRECT ANSWERS ✔✔*Sever
|\ |\ |\ |\ |\ |\ |\
hyperglycemia - BS >600. *Profound dehydration, plasma |\ |\ |\ |\ |\ |\ |\
osmolality >320 Osm/kg. *Neurological Changes - decreased
|\ |\ |\ |\ |\ |\ |\
mentation due to dehydration. S/S could mimic CVA. Absences of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
significant ketosis - not present in signficant amounts. GI
|\ |\ |\ |\ |\ |\ |\ |\ |\
symptoms mild. |\
A1C as Diagnostic Tool - CORRECT ANSWERS ✔✔Pts at risk >
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
5.7% -6.4%; Diabetic >6.5% & repeat test. Normal <5.7%
|\ |\ |\ |\ |\ |\ |\ |\
