NM703 GI, DM, and Thyroid Exam Questions with
Revised Answers| Verified 100% Correct
Family hx for diabetes includes - ✔✔diabetes and ethnicity/race (color have higher
incidences including native americans as high as 33% - navajo and sapina)
Social hx for diabetes includes - ✔✔- diet
- exercise
- smoking
- exposure to environmental toxins (pesticide, PCB or arsenic)
Review of systems for diabetes - ✔✔- General such as fever, fatigue, recent weight
loss or gain
- any problems not yet discussed concerning the eyes, heart, renal system, neuro system
Physical exam for diabetes (general physical) - ✔✔- vital signs (an elevation in blood
pressure can cause an increase in blood sugar), height, weight, BMI
- skin: acanthosis nigricans, thickened skin of fingers and hands, skin tags,
- eyes: snellen chart, look at retina and do a fundoscopic exam
- mouth: peridontal disease (more severe in diabetes)
- ears: hearing impairment is common in pts with diabetes
- neck: carotid bruit in older women which could indicate stroke within 2 years
- lungs: looking for evidence of co-morbidity
- heart: abnormalities in rhythm, murmurs, or problems
- feet: inspect for skin lesions, palpate the dorsalis pedis
, - neuro: if complaints of neuropathy or loss of sensation, proprioception (check for
vibration sense and fine touch with monofilament testing), also check achilles and
patellar reflexes
Why does an elevation in blood pressure cause an increase in blood sugar -
✔✔because the epithelium of the vascular tree is effected by the higher levels of
glucose which will cause a constriction
Diagnostic criteria for diabetes (bs labs) - ✔✔1. FBS >or = 126
2. Hgb A1c > or = 6.5%; should be performed in lab not office
Either these repeated or used in combination can dx
3. symptoms of hyperglycemia with a random bgl of >or=200
4. 2 hour plasma glucose >or=200 during a 75g oral glucose tolerance test
Other labs to consider with diabetes - ✔✔- fasting lipid levels (diabetics have
hyperlipidemia)
- serum creatinine (especially if prescribing metformin)
- other renal function tests
- LFT
- urine: complete ua, but especially albuminuria (sign of kidney failure in future)
When might a HgbA1c not be appropriate? - ✔✔- sometimes in pregnancy
- pt has a hemoglobinopathy
or certain anemias that would change the RBC size and type
- recent blood loss or transfusion
What labs to check at follow up visits for diabetes - ✔✔- glucometer readings
Revised Answers| Verified 100% Correct
Family hx for diabetes includes - ✔✔diabetes and ethnicity/race (color have higher
incidences including native americans as high as 33% - navajo and sapina)
Social hx for diabetes includes - ✔✔- diet
- exercise
- smoking
- exposure to environmental toxins (pesticide, PCB or arsenic)
Review of systems for diabetes - ✔✔- General such as fever, fatigue, recent weight
loss or gain
- any problems not yet discussed concerning the eyes, heart, renal system, neuro system
Physical exam for diabetes (general physical) - ✔✔- vital signs (an elevation in blood
pressure can cause an increase in blood sugar), height, weight, BMI
- skin: acanthosis nigricans, thickened skin of fingers and hands, skin tags,
- eyes: snellen chart, look at retina and do a fundoscopic exam
- mouth: peridontal disease (more severe in diabetes)
- ears: hearing impairment is common in pts with diabetes
- neck: carotid bruit in older women which could indicate stroke within 2 years
- lungs: looking for evidence of co-morbidity
- heart: abnormalities in rhythm, murmurs, or problems
- feet: inspect for skin lesions, palpate the dorsalis pedis
, - neuro: if complaints of neuropathy or loss of sensation, proprioception (check for
vibration sense and fine touch with monofilament testing), also check achilles and
patellar reflexes
Why does an elevation in blood pressure cause an increase in blood sugar -
✔✔because the epithelium of the vascular tree is effected by the higher levels of
glucose which will cause a constriction
Diagnostic criteria for diabetes (bs labs) - ✔✔1. FBS >or = 126
2. Hgb A1c > or = 6.5%; should be performed in lab not office
Either these repeated or used in combination can dx
3. symptoms of hyperglycemia with a random bgl of >or=200
4. 2 hour plasma glucose >or=200 during a 75g oral glucose tolerance test
Other labs to consider with diabetes - ✔✔- fasting lipid levels (diabetics have
hyperlipidemia)
- serum creatinine (especially if prescribing metformin)
- other renal function tests
- LFT
- urine: complete ua, but especially albuminuria (sign of kidney failure in future)
When might a HgbA1c not be appropriate? - ✔✔- sometimes in pregnancy
- pt has a hemoglobinopathy
or certain anemias that would change the RBC size and type
- recent blood loss or transfusion
What labs to check at follow up visits for diabetes - ✔✔- glucometer readings
