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Pathophysiology of Diabetes MCQ
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Question 1 |
From which of the following sources is glucose not derivable?
Diet
| |
Glycogen breakdown in the liver
| |
Glucose formation from other macromolecules
| |
Encephalon-derived gluconeogenesis
|
Question 2 |
Which of the following requires a hyperglycaemic state to permit entry of glucose into the cell?
GLUT1
| |
GLUT2
| |
GLUT3 | |
GLUT4
|
Question 3 |
Where is GLUT5 preferentially upregulated?
Hepatocyte | |
Sinusoids
| |
Enterocyte
| |
Islets of Langerhan
|
Question 4 |
Autoimmunity to beta cells of the islets of langerhans would result in what physiological state?
Arousal
| |
Hyperreflexia
| |
Polydipsia
| |
Increase of transmembrane ATPase activity
|
Question 5 |
Which of the following is utilised in fast twitch muscles during long-distance running?
Glycerol catabolism
| |
Glutamine anabolism | |
Alanine catabolism
| |
Cori cycle
|
Question 6 |
Which of the following is a classic function of insulin?
Inhibition of glycogen synthase
| |
Proteolysis
| |
Lipolysis
| |
Mitogenesis
|
Question 7 |
In which state is ketone formation predominant?
Insulin:glucagon ratio is high
| |
Primarily anabolic state of BMR
| |
Immediately post-prandial
| |
Concomitantly unrestrained lipolysis and proteolysis
|
Question 8 |
Beta cell destruction is directly responsible for
Hyperglycaemia
| |
Polyuria | |
Polydipsia
| |
Weight loss
|
Question 9 |
Which of the following are ketone bodies?
Acetone
| |
Acetoacetate
| |
Beta-hydroxybutyrate
| |
All of the above
|
Question 10 |
What do you expect serum count of the hormone released from alpha cells in the type 2 diabetic patient?
Significantly increased
| |
Slightly increased
| |
Decreased | |
No change
|
Question 11 |
DPP4 inhibitors
Reduce insulin resistance
| |
Promote glycosuria
| |
Prevent GLP breakdown
| |
Decrease hepatic gluconeogenesis |
Question 12 |
Which type of cell is upregulated by administration of oral sulfonyureas?
L-cell
| |
D-cell
| |
Alpha cell (islet) | |
Beta cell (islet)
|
Question 13 |
SGLT2 inhibitors will
Prevent breakdown of GLP
| |
Act preferentially on enterocytes of the ileum | |
Increase secretion of insulin directly | |
Reduce proximal convoluted tubular reabsorpative capacity. |
Question 14 |
STEM - Four Questions - A 12 year old male presents with their concerned parents to see a nurse practitioner. 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
| |
Gestational diabetes
| |
DKA |
Question 15 |
The sudden onset of this condition occurs after how much of the beta cells are destroyed?
Half | |
60%
| |
90%
| |
100%
|
Question 16 |
What accounts for the patient’s weightloss?
Cancer | |
Infection | |
Pancreatic insufficiency
| |
Decreased carbohydrate utilisation
|
Question 17 |
The 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?
Calcitonin-deficiency
| |
Crohn’s disease
| |
Graves’ disease
| |
Pott’s disease
|
Question 18 |
Stem Question 1/4
A 59 year old female, Julia, presents to her GP frustrated that she is “peeing more than usual” at work. On general examination she has an obese BMI, is hypertensive and has significantly elevated BGC. 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) |
Question 19 |
Stem Question 2/4
The patient is diagnosed with diabetes. Which HLA-DR type is linked to this form of diabetes?DR1 | |
DR2 | |
DR3 | |
Nil |
Question 20 |
Stem Question 3/4
A patient is found, with further questioning, to have reduced visual acuity and a “blind spot” in her centre of vision. This is best described as?Amaurosis fugax | |
Macrovascular retinopathy | |
IHD | |
Microvascular disease |
Question 21 |
Stem Question 4/4
The patient’s urine is given a Dipstick in clinic which comes positive for nitrites. Why is this the case?Hypertension | |
Chronic kidney disease | |
Elevated glucose in LUTS | |
Alpha islet cell insufficiency |
Question 21 Explanation:
The correct answer is elevated glucose in the LUTS. Due to widespread hyperglycaemia of T2DM, the patient has increased glucose in the urinary tract. This leads to a more nutrient-rich tract for bacteria to colonise. Given her age, biological sex and comorbidity, LUTS (lower urinary tract infections) are common. Nitrites are a classic sign of this.
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