These questions cover some of the fundamental pathophysiology of diabetes and glucose regulation, and finish off with some simple clinical application.
Reviewed by Jonathan Loomes-Vrdoljak
Pathophysiology of Diabetes MCQ
Islets of Langerhan
Increase of transmembrane ATPase activity
Inhibition of glycogen synthase
When insulin:glucagon ratio is high
Primarily anabolic state of basal metabolic rate
During unrestrained lipolysis and proteolysis
All of the above
Reduce insulin resistance
Prevent GLP breakdown
Decrease hepatic gluconeogenesis
Alpha cell (islet)
Beta cell (islet)
Prevent breakdown of GLP
Act preferentially on enterocytes of the ileum
Increase secretion of insulin directly
Reduce proximal convoluted tubular reabsorpative capacity.
STEM 1 - Question 1
A 12 year old male is brought by their concerned parents to see the advanced nurse practitioner (ANP). On general examination the patient has recent unexplained weight loss, confusion and polyuria.Which is the best-fit diagnosis?
Type one diabetes
Insulin insensitive diabetes
Stem 1 - question 2The sudden onset of this condition occurs after how much of the beta cells are destroyed?
Stem 1 - question 3What accounts for the patient’s weight loss?
Decreased carbohydrate utilisation
Stem 1 - question 4The patient also appears to have a goitre. The ANP explains to the family that autoimmune conditions often cluster together. Which concomitant condition may this patient also have?
Stem 2 - Question 1
A 59 year old female, Julia, presents to her GP frustrated that she is “peeing more than usual” at work. On examination she has an obese BMI, is hypertensive and has significantly elevated blood glucose. Other than the given symptom she states she feels fit and well.How is BMI calculated?
Weight (g) / height (m2)
Weight (kg) / height (m2)
Height (m2) / weight (kg)
Height (cm2) / weight (kg)
Stem 2 - Question 2The patient is diagnosed with diabetes. Which HLA subtype is linked to this form of diabetes?
Stem 2 - Question 3On further examination, the patient is found to have reduced visual acuity and a “blind spot” in her centre of vision. This is best described as?
Stem 4 - Question 4The patient’s urine is positive for nitrites. Why is this the case?
Chronic kidney disease
Effect of glycosuria
Alpha islet cell insufficiency