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Pathophysiology of Diabetes MCQ

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Question 1
From which of the following sources is glucose not derivable?
A
Diet
B
Glycogen breakdown in the liver
C
Glucose formation from other macromolecules
D
Encephalon-derived gluconeogenesis
Question 2
Which of the following requires a hyperglycaemic state to permit entry of glucose into the cell?
A
GLUT1
B
GLUT2
C
GLUT3
D
GLUT4
Question 3
Where is GLUT5 preferentially upregulated?
A
Hepatocyte
B
Sinusoids
C
Enterocyte
D
Islets of Langerhan
Question 4
Autoimmunity to beta cells of the islets of langerhans would result in what physiological state?
A
Arousal
B
Hyperreflexia
C
Polydipsia
D
Increase of transmembrane ATPase activity
Question 5
Which of the following is utilised in fast twitch muscles during long-distance running?
A
Glycerol catabolism
B
Glutamine anabolism
C
Alanine catabolism
D
Cori cycle
Question 6
Which of the following is a classic function of insulin?
A
Inhibition of glycogen synthase
B
Proteolysis
C
Lipolysis
D
Mitogenesis
Question 7
In which state is ketone formation predominant?
A
Insulin:glucagon ratio is high
B
Primarily anabolic state of BMR
C
Immediately post-prandial
D
Concomitantly unrestrained lipolysis and proteolysis
Question 8
Beta cell destruction is directly responsible for
A
Hyperglycaemia
B
Polyuria
C
Polydipsia
D
Weight loss
Question 9
Which of the following are ketone bodies?
A
Acetone
B
Acetoacetate
C
Beta-hydroxybutyrate
D
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?
A
Significantly increased
B
Slightly increased
C
Decreased
D
No change
Question 11
DPP4 inhibitors
A
Reduce insulin resistance
B
Promote glycosuria
C
Prevent GLP breakdown
D
Decrease hepatic gluconeogenesis
Question 12
Which type of cell is upregulated by administration of oral sulfonyureas?
A
L-cell
B
D-cell
C
Alpha cell (islet)
D
Beta cell (islet)
Question 13
SGLT2 inhibitors will
A
Prevent breakdown of GLP
B
Act preferentially on enterocytes of the ileum
C
Increase secretion of insulin directly
D
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?
A
Type one diabetes
B
Insulin insensitive diabetes
C
Gestational diabetes
D
DKA
Question 15
The sudden onset of this condition occurs after how much of the beta cells are destroyed?
A
Half
B
60%
C
90%
D
100%
Question 16
What accounts for the patient’s weightloss?
A
Cancer
B
Infection
C
Pancreatic insufficiency
D
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?
A
Calcitonin-deficiency
B
Crohn’s disease
C
Graves’ disease
D
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?
A
weight (g) / height (m2)
B
Weight (kg) / height (m2)
C
Height (m2) / weight (kg)
D
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?
A
DR1
B
DR2
C
DR3
D
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?
A
Amaurosis fugax
B
Macrovascular retinopathy
C
IHD
D
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?
A
Hypertension
B
Chronic kidney disease
C
Elevated glucose in LUTS
D
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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