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FAMILY MEDICINE AQUIFER/329 QUESTIONS AND ANSWERS (A+)
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FAMILY MEDICINE AQUIFER/329QUESTIONS AND ANSWERS (A+)
What disease can hyperthyroidism unmask? -
√Answer :Diabetes
Unmasks glucose intolerance and adversely effects
glucose and lipid management
Quiz :What diseases are associated with T1D? -
√Answer :Hashimotos
Graves
*autoimmune diseases*
Quiz :What is a key component of HHS treatment? -
√Answer :Fluid replacement
In many cases several liters
Quiz :What is the most common underlying cause of
HHS? - √Answer :Decreased fluid intake
UTI
Pneumonia
MI, stroke and PE can also precipitate it
Quiz :Screening for TIID? - √Answer :Normal starts at
45
Or
Overweight with one or more risk factors:
Physical inactivity
,High risk ethnicity
First degree relative with diabetes
Impaired glucose previously
Stage 2 hypertension (140/90)
Low HDL and High TG
gestational diabetes
PCOS
CVD HX
acanthosis
Quiz :Symptoms of hyperglycemia -
√Answer :Unexplained weight loss
Polyuria
Quiz :Dx of diabetes - √Answer :A1C: greater than 6.5
2 hour postprandial over 200
Fasting over 126
Random over 200 with symptoms of hyperglycemia
Quiz :What causes vision changes in someone with
diabetes - √Answer :Darks spots: new blood vessels
forming and leaking
Blurriness: macular edema
Vision changes are a late complication of diabetic
changes.
40% of patients requiring insulin develop retinopathy 5
years later
Quiz :What do retinal hemorrhages look like and what
causes them? - √Answer :Dark blots with indistinct
borders—indicate partial obstruction and infarction
,Quiz :What are cotton wool spots and what does it
mean? - √Answer :White spots with fuzzy borders
Previous areas of infarction, usually with hemorrhages
Quiz :What do microaneurysms look like in the eye? -
√Answer :Punctuate dark lesions— well circumscribed
Quiz :What causes neovascularization? -
√Answer :Hypoxia and vessel occlusion
Quiz :Parts of a diabetic foot exam - √Answer :Dorsalis
pedis and posterior tib pulses
Ankle jerk reflex
Filament testing
Skin for hair loss, breaks in skin, bony prominences etc
Quiz :What labs should be ordered for someone with
diabetes that hasn't been seen for a year? -
√Answer :A1C
Lipid panel
TSH
Creatine/ GFR
B12 levels (metformin Lowers this)
Spot albumin to creatinine ratio (testing for
microalbuminuria)
Quiz :When should moderate intensity statin be
administrated? - √Answer :Age 40-75 with LDL over 70
and DM
, Quiz :When to use high intensity statin? -
√Answer :Moderate risk plus 7.5% estimated 10 yr CVD
risk
Quiz :Goal BP for patients with diabetes? -
√Answer :Less than 130/80
(That is stage 1 hypertension)
Quiz :Does aspirin decrease risk of heart disease in
someone with diabetes and no other CVD risk factors? -
√Answer :No
**only give them aspirin if they have hex of CVD... aka
over 50 with HTN, HLD, smoking, microalbuminuria and
are not at an increase risk of bleeding
Quiz :What A1C is known to decrease microvascular
complications? - √Answer :Less than 7
Quiz :Tx based on A1C - √Answer :Les than
9=metformin
Between 9-10 dual oral therapy
Above 10=insulin
Quiz :How long do you wait before starting someone on
the next step of therapy? - √Answer :3 months of
therapy where the A1C doesnt drop to below 7
Quiz :What is tx goal for patients with essential
hypertension? - √Answer :<130/80
Quiz :When do you start 1 or 2 drugs? - √Answer :start
2 drugs if more than 20/10 increased from the goal
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