Term
1) Which of the following best describes diabetes mellitus type 1?
A) its an autoimmune disease that attacks insulin receptors
B) its an autoimmune disease that attacks alpha cells of the pancreas
C) its an autoimmune disease that attacks beta cells of the pancreas
D) its a genetic disorder associated with the X chromosome
E) its a genetic disorder associated with the Y chromosome |
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Definition
| C) its an autoimmune disease that attacks beta cells of the pancreas |
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2) In diabetes mellitus type 1, the immune system attacks beta cell antigens. Which of the following is a potential antigen?
A) preproinsulin
B) glucose
C) glucagon
D) preproglucagon
E) ketones |
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Definition
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3) What is the significance of Coxsackie B virus in diabetes mellitus type 1?
A) This virus attacks beta cells of the pancreas causing an immune response against these cells.
B) A person with diabetes mellitus type 1 is more susceptible to infection with Coxsackie B.
C) Coxsackie B increases the availability of lipids for energy.
D) Coxsackie B increases the availability of glucose for energy.
E) Coxsackie B increases the availability of proteins for energy. |
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Definition
| A) This virus attacks beta cells of the pancreas causing an immune response against these cells. |
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4) By what percentage has the incidence of diabetes mellitus type 1 increased in the United States over the last twenty years?
A) 0
B) 10
C) 25
D) 50
E) 100 |
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Definition
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5) At what age do symptoms of diabetes mellitus type 1 first appear?
A) at conception
B) at birth
C) before age 5
D) after age 7
E) after age 40 |
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Definition
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6) Which of the following is NOT an effect of epinephrine?
A) stimulate protein synthesis
B) stimulate lipolysis
C) stimulate gluconeogenesis
D) increase blood fatty acid levels
E) increase ketone production |
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Definition
| stimulate protein synthesis |
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Term
7) Which of the following is NOT a symptom of ketoacidosis?
A) dehydration
B) fruity odor to breath
C) decreased ventilation
D) polyuria
E) electrolyte imbalance |
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Definition
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8) Which of the following can NOT cause coma?
A) a person with diabetes mellitus taking too much insulin causing hypoglycemia
B) a person with diabetes mellitus type 1 taking too little insulin causing hyperglycemia
C) a blood osmolarity greater than 350 mOsm
D) a blood glucose concentration greater than 600 mg/dL
E) a partial pressure of carbon dioxide of 40 mm Hg in arterial blood |
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Definition
| a partial pressure of carbon dioxide of 40 mm Hg in arterial blood |
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9) Symptoms of hypoglycemia include all of the following EXCEPT ________.
A) blurred vision
B) hunger
C) tingling sensation
D) polyuria
E) anxiety |
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Definition
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10) Which of the following chemical messengers induces the sensation of feeling full (satiety effect)?
A) insulin
B) glucagon
C) epinephrine
D) acetylcholine
E) somatostatin |
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Definition
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11) In diabetes mellitus, polydipsia is triggered by what hormone?
A) angiotensin II
B) angiotensin I
C) leptin
D) relaxin
E) glucagon |
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Definition
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12) Glycosylation of what protein is used as a marker for measuring blood glucose levels?
A) insulin
B) glucagon
C) albumin
D) fibrin
E) hemoglobin |
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Definition
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13) Which of the following is NOT an adverse effect of glycosylation caused by hyperglycemia?
A) delayed wound healing
B) increased capillary permeability lipolysis
C) beta cell degeneration
D) oxidative stress
E) atherosclerosis |
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Definition
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14) What is the polyol associated with glucose?
A) aldose
B) lactose
C) sorbitol
D) ascorbic acid
E) glycerol |
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Definition
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15) In diabetes mellitus type 1, blood vessel damage occurs primarily through what process?
A) shear stress on the blood vessels due to elevated pressure
B) increase in nitric oxide release from endothelial cells
C) increase in carbon dioxide build up in blood
D) increase in oxygen levels in blood
E) increase in histamine production |
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Definition
| shear stress on the blood vessels due to elevated pressure |
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Term
16) In diabetes mellitus type 2, blood vessel damage occurs primarily through what process?
A) shear stress on the blood vessels due to elevated pressure
B) increase in carbon dioxide levels in blood
C) decrease in nitric oxide release from endothelial cells
D) increase in histamine production
E) sclerosis of the basement membrane |
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Definition
| decrease in nitric oxide release from endothelial cells |
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Term
17) Damage to the microvasculature that occurs with diabetes contributes to which of the following conditions?
A) retinopathy
B) nephropathy
C) neuropathy
D) delayed wound healing
E) all of the above |
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Definition
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18) What is a microaneurysm?
A) small leakage of blood from the microvasculature
B) large leakage of blood from the microvasculature
C) development of new blood vessels
D) weak bulges in the walls of small blood vessels
E) perforation of the basement membrane of fenestrated capillaries |
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Definition
| weak bluges in the walls of small blood vessels |
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Term
19) What is angiogenesis?
A) small leakage of blood from the microvasculature
B) large leakage of blood from the large blood vessels
C) development of new blood vessels
D) weak bulges in the walls of small blood vessels
E) developments of perforations in the basement membrane of fenestrated capillaries |
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Definition
| development of new blood vessels |
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Term
20) What happens when excessive angiogenesis occurs?
A) the new blood vessel walls are weak and tend to leak
B) the new blood vessel walls are stiff and tend to clog
C) the heart can no longer beat strongly
D) the heart rate increases significantly
E) hypotension occurs due to decreased total peripheral resistance |
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Definition
| the new blood vessel walls are weak and tend to leak |
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Term
21) Which of the following is an early sign of diabetic nephropathy?
A) glucose in the urine
B) blood in the urine
C) systemic edema
D) proteinuria
E) frequent urinary tract infections |
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Definition
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22) What is end-stage renal disease?
A) the kidneys fail and dialysis or kidney transplant is essential
B) the glomerular membrane becomes leaky and proteins appear in the urine
C) infection of the kidneys causes blood loss in the urine
D) Bowman's capsule becomes leaky causing a systemic infection
E) Bowman's capsule becomes leaky and proteins appear in the urine |
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Definition
| the kidneys fail and dialysis or kidney tranplant is essential |
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Term
23) What is parasthesia?
A) simultaneous activation of afferent and efferent axons to the same region of the body
B) abnormal sensation of the skin such as tingling or numbness
C) abnormal activation of motor neurons causing muscle twitches
D) unpleasant sensation produced by innocuous stimuli
E) muscle spasms |
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Definition
| abnormal sensation of the skin such as tingling or numbness |
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Term
24) What is dysthesia?
A) unpleasant sensation produced by innocuous stimuli
B) numbness
C) tingling sensation
D) muscle twitches
E) muscle spasms |
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Definition
| unpleasant sensation produced by innocuous stimuli |
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Term
25) Diabetic neuropathies generally affect what area of the nervous system?
A) brain
B) spinal cord
C) peripheral nervous system
D) sensory receptors
E) glial cells |
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Definition
| peripheral nervous system |
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Term
26) Which of the following does NOT contribute to diabetes enhanced atherosclerosis?
A) increased lipid transport in LDLs
B) increased production of reactive oxygen species
C) increased glycosylation
D) microvascular disease
E) increased lipid transport in HDLs |
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Definition
| increased lipid transport in HDLs |
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Term
27) Which of the following is characteristic of diabetic cardiomyopathy?
A) decreased stroke volume
B) decreased heart rate
C) decreased size of the heart
D) decreased likelihood of myocardial infarction
E) All of the above |
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Definition
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28) What is silent myocardial ischemia?
A) a heart attack without pain
B) a stroke
C) a cardiac arrhythmia that decreases contractility of the atria
D) a cardiac arrhythmia that decreases contractility of the ventricles
E) a cardiac arrhythmia that shuts down the pacemaker cells of the SA node |
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Definition
| a heart attack without pain |
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Term
29) Why do many diabetics have to have a foot amputated?
A) decreased blood flow to the foot causes gangrene
B) decreased blood flow to the foot causes extreme pain that can only be relieved by amputation
C) neuropathy causes intense pain that can only be relieved by amputation
D) decreased blood flow to the foot causes wounds to develop that will not heal
E) abnormal wound healing coupled to lack of sensation from the foot can lead to gangrene |
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Definition
| abnormal wound healing coupled to lack of sensation from the foot can lead to gangrene |
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Term
30) What is the correct order of the three steps of wound healing?
A) inflammation - remodeling - proliferation
B) proliferation - inflammation - remodeling
C) remodeling - inflammation - proliferation
D) proliferation - remodeling - inflammation
E) inflammation - proliferation - remodeling |
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Definition
| inflammation - proliferation - remodeling |
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31) What two cytokines released by platelets during hemostasis promote inflammation?
A) transforming growth factor beta and platelet derived growth factor
B) interleukin 1 and thrombin
C) interleukin 2 and platelet derived growth factor
D) thrombin and leukotriene
E) prostaglandin I2 and platelet factor 3 |
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Definition
| transforming growth factor beta and platelet derived growth factor |
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Term
32) What cell type initiates the inflammatory response?
A) macrophages
B) neutrophils
C) eosinophils
D) fibroblasts
E) lymphocytes |
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Definition
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33) Phagocytosis of debris in the area of wound is carried out by what cell types?
A) lymphocytes and fibroblasts
B) neutrophils and fibroblasts
C) eosinophils and neutrophils
D) basophils and eosinophils
E) macrophages and neutrophils |
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Definition
| macrophages and neutrophils |
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34) What cell type lays down the new extracellular matrix as a wound heals?
A) neutrophils
B) fibroblasts
C) monocytes
D) macrophages
E) megakaryocytes |
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Definition
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35) What cell type secretes collagen as a wound heals?
A) neutrophils
B) monocytes
C) macrophages
D) keratinocytes
E) fibroblasts |
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Definition
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36) What are epidermal cells that proliferate to cover the opening of a wound?
A) fibroblasts
B) macrophages
C) keratinocytes
D) neutrophils
E) granule cells |
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Definition
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37) Collagen becomes organized and cross-linked during what phase of wound healing?
A) hemostasis
B) proliferation
C) remodeling
D) inflammation
E) angiogenesis |
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Definition
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38) What effect does diabetes have on wound healing?
A) speeds it up by increasing angiogenesis
B) speeds it up by increasing the rate of proliferation
C) speeds it up, but in the process leads to a larger scar formation
D) slows it down by increasing inflammation
E) delays it by slowing the rate of all phases |
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Definition
| delays it by slowing the rate of all phases |
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Term
39) Adequate treatment of diabetes includes maintaining fasting blood glucose levels below what value?
A) 60 mg/dL
B) 85 mg/dL
C) 100 mg/dL
D) 115 mg/dL
E) 130 mg/dL |
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Definition
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40) Dietary control of diabetes mellitus type 1 includes limiting the intake of ________.
A) carbohydrates
B) proteins
C) cholesterol
D) triglycerides
E) cellulose |
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Definition
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41) What is the primary medicine for regulating diabetes mellitus type 1?
A) insulin
B) sulfonureas
C) biguanides
D) glucagon
E) glucagon inhibitors |
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Definition
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42) What diabetes medication stimulates insulin release from beta cells of the pancreas?
A) none
B) biguanides
C) thiazolidinediones
D) sulfonureas
E) alpha-glucosidase inhibitors |
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Definition
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43) How do alpha-glucosidase inhibitors decrease blood glucose levels?
A) stimulating insulin release from beta cells of the pancreas
B) inhibiting gluconeogenesis in the liver
C) inhibiting glycogenesis in the liver
D) inhibiting digestion of carbohydrates in the small intestine
E) stimulating glycogenesis in the liver |
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Definition
| inhibiting digestion of carbohydrates in the small intestine |
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Term
44) What medicine for the treatment of diabetes sensitizes tissue to insulin?
A) glucagon
B) sulfonureas
C) alpha-glucosidase inhibitors
D) biguanides
E) thiazolidinediones |
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Definition
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