Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
21 Diabetes mellitus MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 9 practice questions
- Type 1 diabetes
- Islet autoantibodies
- Complications
- Hypoglycaemia
- Glucose-lowering treatment
- DKA
- Insulin therapy
- Transplantation and foot disease
1. A patient with fasting hyperglycaemia has no overnight hypoglycaemia on CGM, and another injects into the same site with erratic control. Which statements are correct?
- ASomogyi effect, and infection
- BOvereating, and allergy
- CThe dawn phenomenon with inadequate basal insulin, and lipohypertrophy prevented by rotating sites
- DInsulin resistance, and oedema
Show answer
C. The dawn phenomenon with inadequate basal insulin, and lipohypertrophy prevented by rotating sites CGM has found little support for Somogyi; injecting into the same place alters absorption.
2. A 60-year-old with type 2 diabetes and previous MI has HbA1c above target on metformin, and another has been above target for years on three oral agents. Which statements are correct?
- AUse a GLP-1 receptor agonist or SGLT2 inhibitor for cardiovascular protection, and do not delay injectable therapy
- BUse pioglitazone, and stop treatment
- CUse a sulphonylurea, and add a fourth oral drug
- DUse a DPP-4 inhibitor, and wait
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A. Use a GLP-1 receptor agonist or SGLT2 inhibitor for cardiovascular protection, and do not delay injectable therapy GLP-1 agonists and SGLT2 inhibitors protect against cardiovascular disease; injectable therapy should not be delayed when levels stay above target for months or years.
3. A patient with type 1 diabetes and end-stage kidney disease is offered transplantation, and a diabetic with a foot ulcer has reduced sensation and one absent pulse. Which statements are correct?
- APancreas alone is commonest, and the foot is red
- BIslet transplant is commonest, and the foot is green
- CKidney alone is commonest, and the foot is low risk
- DSimultaneous pancreas-kidney is most commonly performed with over 95% one-year survival, and the foot is amber risk
Show answer
D. Simultaneous pancreas-kidney is most commonly performed with over 95% one-year survival, and the foot is amber risk SPK is the commonest procedure; red is reduced sensation and absent pulses; amber is reduced sensation or absent pulses.
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