Deck 13: Special Topic: Diabetes Mellitus

Question 1

Susan Littlehorse (28 years old, obese, and pregnant) complains of burning urine to you, her physician at the Indian Health Service. Blood tests show hemoglobin A1c concentrations over 9%. What is your initial diagnosis? How do you test your idea? How should her condition be treated? What are some potential problems she may experience in the future?

Answer 1

Susan seems to have gestational diabetes. You will need to perform a glucose challenge test to confirm your initial diagnosis. You should suggest to her that she begin a healthier lifestyle: a better diet and regular exercise. If the condition is not resolved, then you may need to prescribe insulin or other medications.
There is risk to Susan of developing preeclampsia during pregnancy and of having a baby with excessive birth weight, which could lead to a difficult delivery or a cesarean section. Furthermore, Susan may subsequently develop type 2 diabetes. The child has a greater chance of becoming obese and of having type 2 diabetes later in life.

Question 2

Buford is a very successful high school athlete who has been diagnosed with diabetes. He needs to do well in sports so that he can receive a university scholarship. He dreams of getting into the pros, too - his whole family is counting on him! However, he doesn't want to go through the entire regimen his doctor has prescribed for him because he thinks it cuts into his sports time. What do you need to tell him about sticking to his diabetic treatment plan?

Answer 2

Diabetes has serious long-term complications. It can cause heart attacks and strokes because of fatty deposits in the arteries. Additionally, the same damage to blood vessels can cause serious organ system failures elsewhere in his body: eyes, kidneys, and extremities. Therefore, if he doesn't do what he is told, he could end up blind, hooked up to a kidney machine, and missing a few parts!

Question 3

Which of the following is a likely side effect of gestational diabetes?

A) impotence
B) preeclampsia
C) low blood pressure
D) low birth weight

Answer 3

B

Question 4

You are worried about your friend Mary, a type 1 diabetic. She is nauseated, short of breath, tired, and confused. She says not to worry because she just has a case of the flu. What diagnostic test should you urge her to perform to make sure that there is nothing more serious going on?

A) blood bilirubin
B) urinary ketones
C) blood pressure
D) stress test for the heart

Question 5

Marsha says she sometimes has ketoacidosis. What kind of diabetes is she more likely to have, and how did she develop ketoacidosis? Why is ketoacidosis dangerous, and how can she detect it in time?

Question 6

This is the major cause of type 2 diabetes.

A) viral infection
B) heart disease
C) insulin resistance
D) being underweight

Question 7

All forms of diabetes mellitus involve defects in the production or function of insulin. The result of this defect in insulin is ________.

A) a lack of glucose in the bloodstream
B) a lack of sodium in the bloodstream
C) a buildup of glucose in the bloodstream
D) a buildup of sodium in the bloodstream

Question 8

Summarize the origins and functions of insulin in the body.

Question 9

Shabir has been diagnosed with diabetes mellitus type 2 and will have his blood tested within the next 2 weeks. He has been warned by his physician to stay on a specific diet, but he loves desserts that are not on his recommended treatment plan. You see him eating a huge piece of birthday cake, and when questioned, he says that his doctor will never know because he will fast for a few days before his blood glucose test and fool the physician. What blood test might the physician order to detect Shabir's deception?

A) hemoglobin A1c
B) white blood cell count
C) HDL
D) electrolytes

Question 10

Your friend Matti accidentally injected himself with double the correct dosage of insulin. He has collapsed. Quick! It's all up to you. What do you do?

A) Give him CPR.
B) Inject him with thyroxine.
C) Give him glucagon.
D) Inject him with more insulin.

Question 11

Which of the following is true of diabetes mellitus type 1?

A) Patients always require insulin.
B) Cells become resistant to insulin.
C) Most people with diabetes mellitus have this form.
D) It can be delayed or prevented.

Question 12

Tunde is worried that she has diabetes since a lot of her family has it. Which of the following blood findings would set her mind most at ease?

A) 400 mg/dl glucose
B) 90 mg/dl glucose
C) 30% Hb A1c hemoglobin
D) 9% Hb A1c hemoglobin

Question 13

Saito is in charge of public health in his county and wants to reduce the rate of type 2 diabetes there. What kinds of health measures should he promote?

Question 14

Which of the following is recommended for diabetes mellitus patients?

A) smoking
B) binge drinking
C) inactivity
D) controlling stress