BSNC 2000 LATEST 2026 STUDY GUIDE QUESTIONS AND
SOLUTIONS GRADED A+
✔✔conditions associated with insulin resistance - ✔✔acanthosis nigricans (dark, velvety
areas of skin in skin creases)
polycystic ovarian syndrome (androgen excess and insulin resistance)
✔✔how is waist circumference measured? - ✔✔waist:hip
✔✔how is T1DM identified? - ✔✔autoantibodies in the blood
no or very low blood C-peptide levels
elevated ketones
✔✔blurred vision and hyperglycemia - ✔✔swelling of the lens (glucose enters cells of
the lens -> sorbitol; osmotically active, water follows)
✔✔fatigue associated with DM - ✔✔dec plasma volume (dehydration from polyuria|),
poor perfusion (viscous, sticky blood), cells are starved of glucose for ATP production
despite BG levels high
✔✔manifestations of poor circulation - ✔✔delayed wound healing
tingling, numbness
high freq of infections
✔✔rapid acting insulin - ✔✔lispro, aspart, glulisine
✔✔Short acting insulin - ✔✔regular
✔✔Intermediate acting insulin - ✔✔NPH
✔✔Long acting insulin - ✔✔glargine, detemir
✔✔what is the first choice of pharmacological therapy for T2DM? - ✔✔Metformin
(Biguanide)
dec hepatic glucose prod
dec intestinal glucose absorption
inc insulin sensitivity
*does not act on the pancreas - does not cause hypoglycemia
✔✔Somogyi effect - ✔✔hypoglycemia followed by rebound hyperglycemia
, - compensatory mechanism (inc in catecholamines, glucagon, cortisol and GH -> inc
BG)
✔✔Dawn phenomenon - ✔✔Early morning (0500-0900) glucose elevation produced by
the release of growth hormone, which decreases peripheral uptake of glucose resulting
in elevated morning glucose levels. Admin of insulin at a later time in day will coordinate
insulin peak with the hormone release.
*no antecedent hypoglycemia
✔✔A1C - ✔✔amount of glucose attached to hemoglobin (avg over 2-3 mo)
management of DM involved monitoring of A1C levels - determines if current
med/management is working
✔✔urinalysis in DM - ✔✔assessing for ketones in the urine (make sure pt is not
experiencing diabetic ketoacidosis)
*esp T1DM
ketones = severe hyperglycemia
assess for red blood cells (hematuria) - glomerular disease?
assess for proteins (albuminuria) diabetic nephropathy?
assess for UTI
✔✔lipid profile DM - ✔✔DM = higher risk for hyperlipidemia
tests for total cholesterol level, triglyceride level, HDL and LDL
*important to monitor so cardiovascular complications do not occur
✔✔DM foot care - ✔✔full foot exam annually
podiatrist trim toenails
do not walk around barefoot
test water temp before stepping in bath
wash and check feet daily
socks and shoes should fit well
✔✔how many British Columbians live with chronic pain every day? - ✔✔1 in 5
✔✔what amount of urine signals desire to urinate? - ✔✔150-250mL
SOLUTIONS GRADED A+
✔✔conditions associated with insulin resistance - ✔✔acanthosis nigricans (dark, velvety
areas of skin in skin creases)
polycystic ovarian syndrome (androgen excess and insulin resistance)
✔✔how is waist circumference measured? - ✔✔waist:hip
✔✔how is T1DM identified? - ✔✔autoantibodies in the blood
no or very low blood C-peptide levels
elevated ketones
✔✔blurred vision and hyperglycemia - ✔✔swelling of the lens (glucose enters cells of
the lens -> sorbitol; osmotically active, water follows)
✔✔fatigue associated with DM - ✔✔dec plasma volume (dehydration from polyuria|),
poor perfusion (viscous, sticky blood), cells are starved of glucose for ATP production
despite BG levels high
✔✔manifestations of poor circulation - ✔✔delayed wound healing
tingling, numbness
high freq of infections
✔✔rapid acting insulin - ✔✔lispro, aspart, glulisine
✔✔Short acting insulin - ✔✔regular
✔✔Intermediate acting insulin - ✔✔NPH
✔✔Long acting insulin - ✔✔glargine, detemir
✔✔what is the first choice of pharmacological therapy for T2DM? - ✔✔Metformin
(Biguanide)
dec hepatic glucose prod
dec intestinal glucose absorption
inc insulin sensitivity
*does not act on the pancreas - does not cause hypoglycemia
✔✔Somogyi effect - ✔✔hypoglycemia followed by rebound hyperglycemia
, - compensatory mechanism (inc in catecholamines, glucagon, cortisol and GH -> inc
BG)
✔✔Dawn phenomenon - ✔✔Early morning (0500-0900) glucose elevation produced by
the release of growth hormone, which decreases peripheral uptake of glucose resulting
in elevated morning glucose levels. Admin of insulin at a later time in day will coordinate
insulin peak with the hormone release.
*no antecedent hypoglycemia
✔✔A1C - ✔✔amount of glucose attached to hemoglobin (avg over 2-3 mo)
management of DM involved monitoring of A1C levels - determines if current
med/management is working
✔✔urinalysis in DM - ✔✔assessing for ketones in the urine (make sure pt is not
experiencing diabetic ketoacidosis)
*esp T1DM
ketones = severe hyperglycemia
assess for red blood cells (hematuria) - glomerular disease?
assess for proteins (albuminuria) diabetic nephropathy?
assess for UTI
✔✔lipid profile DM - ✔✔DM = higher risk for hyperlipidemia
tests for total cholesterol level, triglyceride level, HDL and LDL
*important to monitor so cardiovascular complications do not occur
✔✔DM foot care - ✔✔full foot exam annually
podiatrist trim toenails
do not walk around barefoot
test water temp before stepping in bath
wash and check feet daily
socks and shoes should fit well
✔✔how many British Columbians live with chronic pain every day? - ✔✔1 in 5
✔✔what amount of urine signals desire to urinate? - ✔✔150-250mL
