1. Diabetic ketoacidosis (DKA) is characterized by high anion gap, low pH, and low bicarbonate levels except serum bicarbonate may be greater than 15 meq/L. 2. Microalbuminuria is the earliest manifestation of diabetic nephropathy. Increased glomerular filtration rate occurs later while decreased glomerular filtration rate is a late feature. 3. The most common pattern of dyslipidemia in diabetes is increased triglycerides and decreased HDL cholesterol levels.

1. QUIZ ON
DIABETES

2. All of the following are true about maturity onset diabetes of the young
(MODY) Except?
A.It is an Autosomal dominant trait.
B.MODY 4 is the most common form.
C.Diabetic Ketoacidosis is uncommon
D.Insulinopenia is present

3. • 40 year old male patient with type 2 diabetes mellitus is now
diagnosed with hypertension.Which of the following antihypertensive
drugs will you not prefer in this patient?
A. Hydrochlorthiazide
B. Losartan
C. Lisinopril
D. Furosemide

4. • A type 2 diabetic patient who was recently Started on treatment
complains of frequent urination ,fever, and burning micturition.Which
of the following drugs is most likely responsible for these symptoms?
A. Dapagliflozin
B. Metformin
C. Glipizide
D. Exenatide

5. • A 60 year old presents to casuality with confusion ,vomitting, and
abdominal pain.His blood sugars – 421mg/dl. Urine ketones are 3+.
He is treated with IV Normal saline and Insulin infusion.Which of the
following should be monitored for ?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hyponatremia

6. Which of the following is not a clinical feature of Diabetes mellitus?
A. Weight loss
B. Osmotic diuresis
C. Weight gain
D. Hypovolemia

7. Which of the following patients can be diagnosed with diabetes
mellitus?
A. A patient with RBS of 210mg/dl
B. A patient with FBS of 125 mg/dl and 2 – Hour PPBS of 199 mg/dl
C. A patient with symptoms of diabetes and RBS of 192 mg/dl
D. A patient with HbA1c >6.5%

8. • All of the Following drugs can be used in treatment of patients with
type 1 diabetes Except:
A. Acarbose
B. Pramlintide
C. Metformin
D. Insulin

9. • Which of the following is incorrect about Afrezza (Insulin)?
A. It is available as a powder form for inhalation.
B. It can cause bronchospasm
C. It does not cause hypoglycemia.
D. It is a rapid acting form.

10. Which of the following mechanisms is predominantly responsible for an
increase in the fasting plasma glucose level of the patients with type 2
Diabetes mellitus?
A. Increased hepatic gluconeogenisis.
B. Decreased peripheral uptake of glucose.
C. Decreased glycogenesis in muscles.
D. Decreased hepatic glycogenesis

11. Distinguishing feature between hyperglycemic hyperosmolar state and
diabetic ketoacidosis include all of the following except:
A. Ketosis
B. Anion gap
C. Hypotension
D. Arterial pCO2

12. • What is the most common pattern of dyslipidemia associated with
diabetes mellitus?
A. Increased triglycerides and decreased HDL.
B. Increased LDL and decreased HDL.
C. Increased VLDL and decreased HDL.
D. Increased triglycerides and increased VLDL.

13. Which of the following is not a feature of Diabetic ketoacidosis?
A. Low serum sodium
B. High anion gap
C. Serum pH < 7.4
D. Serum bicorbonate > 15 meq /L

14. • What is the most Common Pattern of Dyslipedemia associated with
diabetes mellitus?
A.Increased triglycerides and Decreased HDL
B. Increased LDL and decreased HDL
C.Increased VLDL and Decreased HDL
D. Increased triglycerides and increased VLDL

15. • Which of the following is the earliest manifestation of Diabetic
nephropathy?
A. Microalbimunuria
B. Increased glomerular filtration rate
C. Decreased glomerular filtration rate
D. Increased Urine PCR

16. A patient with diabetic ketoacidosis has severe abdominal pain.Which
of the following is the recommended test to rule out acute
pancreatitis?
A.Lipase
B.Elastase
C.Amylase
D.Trypsinogen

17. • A 45 year old man has been diagnosed with type 2 diabetes
mellitus.When should you refer him to an ophthalmologist?
A. Within one year of diagnosis
B. Immediately at the time of diagnosis
C. Within five years of diagnosis.
D. Within three years of diagnosis.

18. • A 50 year old man with type 2 diabetes mellitus is found to have a 24
hour urinary Albumin of 250 mg. Which of the following drugs may be
prescribed to reduce the progression of this condition?
A. Hydrochlorthiazide
B. Enalapril
C. Amiloride
D. Eplerenone

19. • You are counselling a patient with longstanding ,poorly controlled
diabetes mellitus. Advising tight glycemic control in this patient would
not improve which of the following?
A. Neuropathy
B. Retinopathy
C. Peripheral vascular disease
D. Nephropathy

20. • Diabetic drug that should be stopped immediately with a creatinene
of 5.6 mg/dl is?
A. Metformin
B. Linagliptin
C. Metoprolol
D. Insulin

21. • What is the most common clinical presentation of diabetic
neuropathy?
A. Autonomic neuropathy
B. Mononeuropathy
C. Distal polyneuropathy
D. Polyneuropathy

22. A pathologist is studying a renal biopsy sample from a patient with
suspected diabetic nephropathy.Which of the following biopsy findings
is pathognomic for this condition?
A. Diffuse glomerulosclerosis
B. Nodular glomerulosclerosis
C. Kimmelsteil wilsons nodules
D. Basement membrane thickening

23. • Which of the following is the leading cause of death in children with
diabetic ketoacidosis?
A. Acute respiratory distress syndrome
B. Cardiac arrhythmia
C. Cerebral edema
D. Acute kidney injury

24. • A patient with chronic diabetes presents to the OPD for his annual
checkup.A small painless ulcer noted over his right foot.All of the
following factors can be implicated in the causation of his foot ulcer
Except:
A. Venous stasis
B. Neuropathy
C. Immunosuppression
D. Ischemia

25. Which of the following is the earliest manifestation of Diabetic
nephropathy?
A. Microalbiminuria
B. Increased GFR
C. Decreased GFR
D. Increased urine PCR

26. • Which of the following is not a feature of Diabetic Ketoacidosis?
A. Low serum sodium
B. High Anion gap
C. Serum pH is < 7.4
D. Serum bicorbonate >15 meq/L