Multiple Choice Question on Diabetes Mellitus: Pathogenesis, Diagnosis and Treatment


1) Diabetes mellitus is a disorder characterized by hyperglycemia. Which of the following are not the common characteristic features of  for type 2 diabetes mellitus 
a) Impaired insulin secretion
b) Increased Insulin resistance 
c) Excessive hepatic glucose production
d) Diabetic ketoacidosis

2) Which of the following are the characteristic features of type 1 diabetes mellitus?
a) Type 1 diabetes is caused by an absolute deficiency of insulin.
b) Type 1 diabetes is associated with the autoimmune destruction of beta cells. 
c) Patients with type 1 diabetes present with diabetic ketoacidosis
d) All of the above
 
3) Which of the following serum measurements are not used for diagnosis of diabetes mellitus
a) Fasting blood glucose
d) Postprandial blood glucose 
c) Glycated Hemoglobin HbA1c
d) Insulin 

4) Which of the following is not the criteria for the diagnosis of diabetes?
a) Fasting blood glucose >126 mg/dL
b) 2-hour postprandial glucose >140 mg/dL
c) HbA1C > 6.5%
d) Random blood glucose >200 mg/dL with classical symptoms

5) Which of the following is not auto-antibodies is a marker for type 1 diabetes?
a) Antibodies to GAD65
b) Antibodies to tyrosine phosphatase IA-2 and IA-2 beta
c) Zinc transporter 8 (ZnT8)
d) None of the above

6) Prediabetes is the term used for individuals that do not meet the criteria for diabetes but are too high to be considered normal. Which of the following statement accurately characterize prediabetes?
a) Fasting blood glucose from 120-180 mg/dL
b) Fasting blood glucose from 126-140 mg/dL
c) Fasting blood glucose from 110-125 mg/dL
d) All of the above

7) All of  the following drugs are oral hypoglycemic drugs except 
a) Metformin
b) Sulphonylureas
c) Thiazolidinediones
d) Insulin

8) Which of the following are the pharmacological effect of metformin
a) Reduced glucose absorption from the gut
b) Facilitation of glucose entry into muscle 
c) Inhibition of gluconeogenesis in the liver 
d) All of the above

9) Sulphonylureas increase insulin secretion by beta cells. Sulphonylureas acts by binding sulphonylurea receptor and inhibit
a) ATP dependent K+ channel
b) Voltage-gated calcium channel
c) GLUT-2 
d) None of the above

10) Glitazone is an oral hypoglycemic drug used to treat hyperglycemia. Which of the following is not correct regarding the mechanism of action of Glitazones
a) Glitazone binds to the peroxisome-proliferating activator receptor gamma, 
b) Peroxisome-proliferating activator receptor-gamma is a cell surface receptor found in adipocytes
c) Glitazone increases insulin sensitivity 
d) None of the above 

11) Acarbose, an alpha-glucosidase inhibitor, is a drug used to treat hyperglycemia. Which of the following is the correct mechanism regarding the acarbose
a) Acabarose acts in the adipose tissue
b) Acarbose increases insulin sensitivity
c) Acarbose delays absorption of starch and sucrose
d) All of the above

12) Which is of the following is not the consequence of insulin deficiency in carbohydrate metabolism?
a) Increased blood glucose concentration
b) Increased glycogen breakdown
c) Decreased peripheral glucose utilization
d) Decreased gluconeogenesis

13) Which of the following is the consequence of insulin deficiency in protein metabolism?
a) Decreased protein breakdown
b) Increased synthesis of amino acids
c) Decreased ureagenesis
d) Increased protein synthesis 

14) Which of the following is not the consequence of insulin deficiency in lipid metabolism?
a) Increased triglyceride breakdown
b) Increased level of free fatty acids
c) Increased ketogenesis
d) Increased lipogenesis

15) The acute complications of uncontrolled diabetes mellitus include hyperosmolar coma, diabetic ketoacidosis, etc. Which of the following statement is false regarding the hyperglycemia hyperosmolar coma?
a) Severe hyperglycemia shifts fluid from the intracellular to the extracellular space
b) Polyuria increases volume of extracellular space and decreased renal blood flow
c) The severe loss of intracellular fluid from the brain causes the coma
d) Increased serum osmolality

16) In Diabetic ketoacidosis, the lack of insulin causes increased production of ketone bodies. Which of the following laboratory results are likely seen in  diabetic ketoacidosis
a) Decreased arterial blood pH, increased blood glucose, decreased bicarbonate ion concentration 
b) Decreased arterial blood pH, increased blood glucose, decreased anion gap
c) Increased arterial blood pH, increased blood glucose, decreased bicarbonate ion concentration
d) All of the above

17) The long term complication of diabetes includes retinopathy, neuropathy, and nephropathy. The retinopathy (cataract) is caused by the accumulation of sorbitol in the affecting tissues. Which of the following enzyme is involved in the conversion of glucose to sorbitol?
a) Galactokinase
b) Aldose reductase
c) Glucokinase
b) Aldolase B

18) Which of the following laboratory measurement best indicate the blood glucose control over a period of weeks
a) Measurement of blood glucose
b) Measurement of HbA1C
c) Measurement of urinary ketone bodies
d) Measurement of insulin

19) Which of the following enzyme would be more active in diabetic patients?
a) Glucokinase
b) Fatty acid synthase
c) Lipoprotein lipase
d) Hormone-sensitive lipase

20) The therapeutic goal of managing and preventing hyperlipidemic complications of diabetes mellitus include
a) LDL <100 mg/dL
b) HDL> 40 mg/dL
c) Triglycerides <150 mg/dL
d) All of the above


Answers
1-d) Diabetic ketoacidosis
2-d) All of the above
3-d) Insulin 
4-b) 2-hour postprandial glucose >140 mg/dL
5-d) None of the above
6-c) Fasting blood glucose from 110-125 mg/dL
7-d) Insulin
8-d) All of the above
9-a) ATP dependent K+ channel
10-b) Peroxisome-proliferating activator receptor-gamma is a cell surface receptor found in adipocytes
11-c) Acarbose delays absorption of starch and sucrose
12-d) Decreased gluconeogenesis
13-d) Increased protein synthesis
14)-d) Increased lipogenesis
15-b) Polyuria increases the volume of extracellular space and decreased renal blood flow
16-a) Decreased arterial blood pH, increased blood glucose, decreased bicarbonate ion concentration 
17-b) Aldose reductase
18-b) Measurement of HbA1C
19-d) Hormone-sensitive lipase
20-d) All of the above