Normal Laboratory Reference values
Laboratory Test | Normal Range in US Units | Normal Range in SI Units | To Convert U.S. to SI Units |
ALT (Alanine aminotransferase) | F 7-30 units/L | F 0.12-0.50 µkat/L | x 0.01667 |
M 10-55 units/L | M 0.17-0.92 µkat/L | ||
Albumin | 3.1 – 4.3 g/dL | 31 – 43 g/L | x 10 |
Alkaline Phosphatase | F 30-100 units/L M 45-115 units/L | F 0.5-1.67 µkat/L M 0.75-1.92 µkat/L | x 0.01667 |
Amylase (Serum) | 53-123 units/L | 0.88-2.05 nkat/L | x 0.01667 |
AST (Aspartate aminotransferase) | F 9-25 units/L | F 0.15-0.42 µkat/L | x 0.01667 |
M 10-40 units/L | M 0.17-0.67 µkat/L | ||
Basophils | 0-3% of lymphocytes | 0.0-0.03 fraction of white blood cells | x 0.01 |
Bilirubin – Direct | 0.0-0.4 mg/dL | 0-7 µmol/L | x 17.1 |
Bilirubin – Total | 0.0-1.0 mg/dL | 0-17 µmol/L | |
Blood pressure | Normal: 120/70 to 120/80 millimeters of mercury (mmHg). Top number is systolic pressure, when heart is pumping. Bottom number is diastolic pressure when heart is at rest. Blood pressure can be too low (hypotension) or too high (hypertension). | No conversion | |
C peptide | 0.5-2.0 ng/mL | 0.17-0.66 nmol/L | x 0.33 |
Calcium, serum | 8.5-10.5 mg/dL | 2.1-2.6 mmol/L | x 0.25 |
Calcium, urine | 0-300 mg/24hr | 0.0-7.5 mmol/24hr | x 0.025 |
CO2 (Bicarbonate) | 20-32 mmol/L | 20-32 mmol/L | No conversion |
Chloride | 95-108 mmol/L | 95-108 mmol/L | No conversion |
Cholesterol, Total | <200 mg/dL | <5.17 mmol/L | x 0.02586 |
Marginal | 200-239 mg/dL | 5.17-6.18 mmol/L | |
High | >239 mg/dl | >6.18 mmol/L | |
Cholesterol, LDL | <100 mg/dL | <2.59 mmol/L | |
Marginal | 100-159 mg/dL | 2.59-4.14 mmol/L | |
High | 160-189 mg/dL | 4.14 – 4.89 mmol/L | |
Very High | >190 mg/dL | >4.91 mmol/L | |
Cholesterol, HDL | >60 mg/dL | >1.55 mmol/L | |
Moderate | 40-60 mg/dL | 1.03-1.55 mmol/L | |
Low (heart risk) | <40 mg/dL | <1.03 mmol/L | |
Cortisol: serum free (urine) | 0-25 µg/dL (depends on time of day) | 0-690 nmol/L | x 27.59 |
20-70 µg/dL | 55-193 nmol/24hr | x 2.759 | |
Creatine kinase | F 40-150 units/L M 60-400 units/L | F 0.67-2.50 µkat/L M 1.00-6.67 µkat/L | x 0.01667 |
Creatinine (urine) | F 0.6-1.8 g/day M 0.8-2.4 g/day | F 5.3-15.9 mmol/day M 7.1-21.2 mmol/day | x 88.4 |
DHEA | F 130-980 ng/dL M 180-1250 ng/dL | F 4.5-34.0 nmol/L M 6.24-43.3 nmol/L | x 0.03467 |
DHEA Sulfate | F Pre-menopause: 12-535 µg/dL | F Pre-menopause: 120-5350 µg/L | x 10 |
F Post-menopause: 30-260 µg/dL | F Post-menopause: 300-2600 µg/L | ||
M 10-619 µg/dL | M 100-6190 µg/L | ||
Eosinophils | 0-8% of white blood cells | 0.0-0.8 fraction of white blood cells | x 0.01 |
Erythrocyte sedimentation rate (Sed Rate) | F £ 30 mm/h M £ 20 mm/h | F £ 30 mm/h M £ 20 mm/h | No conversion |
Folate | 3.1-17.5 ng/mL | 7.0-39.7 nmol/L | x 2.266 |
Glucose, urine | <0.05 g/dl | <0.003 mmol/L | x 0.05551 |
Glucose, plasma | 70-110 mg/dL | 3.9-6.1 mmol/L | |
Gamma glutamyl transferase (GGT) | F £ 45 U/L M £ 65 U/L | F £ 45 U/L M £ 65 U/L | No conversion |
Laboratory Test | Normal Range in U.S. Units | Normal Range in SI Units | To Convert US to SI Units |
Hematocrit | F 36.0-46.0% of red blood cells | F 0.36-0.46 fraction of red blood cells | x 0.01 |
M 37.0-49.0% of red blood cells | M 0.37-0.49 fraction of red blood cells | ||
Hemoglobin | F 12.0-16.0 g/dL M 13.0-18.0 g/dL | F 7.4-9.9 mmol/L M 8.1-11.2 mmol/L | x 0.6206 |
Lactate dehydrogenase (LDH) (total) | £ 270 U/L | £ 4.5 µkat/L | X 0.016667 |
Lactic acid | 0.5-2.2 mmol/L | 0.5-2.2 mmol/L | No conversion |
Leukocytes (WBC) | 4.5-11.0 x 103/mm3 | 4.5-11.0 x 109/liter | No conversion |
Lymphocytes | 16-46% of white blood cells | 0.16-0.46 fraction of white blood cells | x 0.01 |
Mean corpuscular hemoglobin (MCH) | 25.0-35.0 pg/cell | 25.0-35.0 pg/cell | No conversion |
Mean corpuscular hemoglobin concentration (MCHC) | 31.0-37.0 g/dL | 310-370 g/L | x 10 |
Mean corpuscular volume (MCV) | F 78-102 µm3 M 78-100 µm3 | F 78-102 fl M 78-100 fl | No conversion |
Monocytes | 4-11% of white blood cells | 0.04-0.11 fraction of white blood cells | x 0.01 |
Neutrophils | 45-75% of white blood cells | 0.45-0.75 fraction of white blood cells | x 0.01 |
Phosphorus | 2.5-4.5 mg/dL | 0.81-1.45 mmol/L | X 0.323 |
Platelets (Thrombocytes) | 130-400 x 103/µL | 130-400 x 109/L | No conversion |
Potassium | 3.4-5.0 mmol/L | 3.4-5.0 mmol/liter | No conversion |
Red Blood Cell Count (RBC) | F 3.9-5.2 x 106/µL M 4.4–5.8 x 106/µL | F 3.9-5.2 x 1012/L M W 4.4-5.8 x 1012/L | No conversion |
Sodium | 135-145 mmol/liter | 135-145 mmol/liter | No conversion |
Testosterone, total (morning sample) | F 6-86 ng/dL | F 0.21-2.98 nmol/liter | x 0.03467 |
M 270-1070 ng/dL | M 9.36-37.10 nmol/liter | ||
Testosterone, Age 20-40
Unbound Age 41-60
Age 61-80 | F 0.6-3.1 pg/mL M 15.0-40.0 pg/mL | F 20.8-107.5 pmol/liter M 520-1387 pmol/liter | x 34.67 |
F 0.4-2.5 pg/mL M 13.0-35.0 pg/mL | F 13.9-86.7 pmol/liter M 451-1213 pmol/liter | ||
F 0.2-2.0 pg/mL M 12.0-28.0 pg/mL | F 6.9-69.3 pmol/liter M 416-971 pmol/liter | ||
Triglycerides Normal (fasting) Borderline High Very High | 40-150 mg/dL 150-200 mg/dL 200-500 mg/dL >500 mg/dL | 0.45-1.69 mmol/liter 1.69-2.26 mmol/liter 2.26-5.65 mmol/liter >5.65 mmol/liter | x 0.01129 |
Urea, plasma (BUN) | 8-25 mg/dL | 2.9-8.9 mmol/liter | x 0.357 |
Urinalysis: pH Specific gravity | 5.0-9.0 | 5.0-9.0 | No conversion |
1.001-1.035 | 1.001-1.035 | ||
WBC (White blood cells, Leukocytes) | 4.5-11.0 x 103/mm3 | 4.5-11.0 x 109/liter | No conversion |
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A 36-year-old African Amerian man with no significant past medical history presents with a 3-week history of polyuria, polydipsia and 20-pound weight loss. His BMI is 22. He has a family history of Graves disease in his mother and celiac disease in a younger sister. He had no evidence of ketoacidosis at presentation and there were no skin tags or acanthosis nigricans.
The patient’s A1C was 9 during his brief period of hospitalization. He was discharged home on metformin and glipizide. In addition, the patient started therapeutic lifestyle interventions. Metformin and glipizide were both uptitrated to their maximal doses. His A1C improved to 8.5% during his three-month clinic visit. He reports feeling much better. What diagnosis should his primary care provider consider?
A 22-year-old woman with a history of PCOS is diagnosed with Gestational diabetes mellitus at 25weeks gestation. Which of these statements regarding the management of GDM is inaccurate?
Which of these is not a clinical marker of insulin resistance?
Which of these medications does not have a direct drug-to-drug interaction with orlistat, a weight loss medication?
A patient with insulin resistance requiring U-500 insulin is admitted to the medicine service. You are consulted for management of hyperglycemia due to the patient’s history of significant insulin resistance. What will be your recommendation?
A couple with T1DM is concerned about the risk of T1DM in their unborn child. What will you tell these expectant parents?
What is the first deficit in the evolution of Type 2 diabetes mellitus?
A patient is started on an antipsychotic agent and develops significant weight gain and newly diagnosed dysglycemia. Which of these medications is a preferred antipsychotic agent with an acceptable metabolic profile?
34-year-old Hispanic woman with class III obesity was admitted to the medicine service due to diabetic ketoacidosis in a newly diagnosed diabetic. Her insulin requirements declined significantly, necessitating discontinuation of insulin a few weeks after discharge from the hospital. She is currently well controlled on metformin 500mg BID with an A1C of 6.4%. Her family history is strong for T2DM (mother, two maternal aunts, and a younger sister). Patient has acanthosis nigricans and multiple skin tags. What is the next step in management
Which of these medications should be avoided in a patient with type 2 diabetes mellitus and an estimated GFR < 60?
A 45-year-old woman with a 3-decade history of T1DM. She has noticed a progressively enlarging tumor in her preferred insulin injection site. She has been admitted on two occasions within the past month for diabetic ketoacidosis. You notice a hard nodular mass in the subcutaneous tissue of the anterolateral abdomen. You inform the patient of the rarity of this clinical finding even in patients with a long-standing history of T1DM. What is the most likely diagnosis?
A primary care provider refers a 36-year-old African American man with a hemoglobinopathy (SC genotype) and poorly controlled T1DM to your practice for optimization of glycemic control. He has obstructive hepatopathy as a consequence of long-standing diabetes. His serum albumin is 1.8. Patient has stage IV chronic kidney disease and is being scheduled for placement of an arterio-venous fistula in the near future. Which of these options is the best way to assess glycemic control in this patient?
Which of these is not a goal of optimal glycemic management of cystic fibrosis-related diabetes (CFRD).
A 54-year-old female with T2DM complicated CKD stage IIIA is referred to a nephrologist. Which of these is an indication for renal biopsy in the setting of presumed diabetic nephropathy?
Which of these drugs or combination of drugs has both antiproteinuric effects and a demonstrable preservation of glomerular filtration rate?
A 42-year-old man with morbid obesity, status post Roux-en-Y gastric bypass, who presented to the emergency room after an unresponsive hypoglycemic event. He had a positive Whipple’s triad. What is the most likely diagnosis based on the results of his biochemical tests obtained after a 72hour fast?
Test | Result |
Proinsulin | Low |
Insulin | Low |
C-peptide | Low |
Oral hypoglycemic agents | Undetectable |
β-hydroxybutyrate | low |
Serum glucose after IM Glucagon | A significant increase in glucose |
A 54-year-old woman with uncontrolled T2DM complicated by nephropathy. She has a consistent blood pressure > 160/90mmHg and is currently on a maximally tolerated dose of lisinopril. What would you recommend next to control her blood pressure?
36-year-old female with PCOS is diagnosed with non-alcoholic fatty liver disease (NAFLD). What is the most important cause of death in NAFLD?
A 32-year-old Female Gravida 2 para 1, with a history of PCOS, presents at 16weeks gestation. She had diet controlled gestational diabetes during her first pregnancy, which resolved post delivery. What should be done next?
67-year-old female with a history of T2DM complicated by retinopathy and neuropathy, was brought to the ED by EMS after a hypoglycemic event. Her chronic anti-hyperglycemic regimen includes metformin, glipizide, and linagliptin. She has an estimated GFR of 50 to 55 (Serum creatinine 1.6 to 1.7) over the preceding two years. The patient was recently started on trimethoprim-sulfamethoxazole for a skin infection. She was found unresponsive in her living room. Her blood glucose was 30mg/dl. The patient recovered after two ampoules of 50% Dextrose and an intramuscular injection of glucagon. What is the most likely explanation for this patient’s hypoglycemic event?
A 30-year-old with class III obesity and PCOS is referred to the endocrine clinic for further management of severe insulin resistance. She is currently on 70 units of Levemir insulin twice a day, Novolog insulin 60units with each meal 3 times a day and SQ liraglutide 1.8mg daily. Her current glycated hemoglobin is 8.4%. You plan on switching her from U-100 insulin to Humulin R U-500 insulin. What is the best approach in this clinical setting?
A 54-year-old man with type 2 diabetes mellitus, hypertension, dyslipidemia, and heart failure. His estimated GFR is 50, normal liver function tests and glycated hemoglobin of 11. His fasting blood glucose readings range from 80mg/dl to 100mg/dl with average daily glucose of 185 mg/dl. He has a remote history of splenectomy due to a blunt abdominal injury and recurrent acute pancreatitis. He is currently on a maximally tolerated dose of metformin. His primary care provider is considering an additional agent to metformin due to his uncontrolled glycohemoglobin. Which of these management options is the next best step?
A 28-year-old woman with class I obesity is motivated to lose weight. She has started an exercise and diet program. Despite adherence to these therapeutic lifestyle interventions, she has been unable to lose 5% of her weight. Her current medications include an oral contraceptive and a daily “health supplement”. The patient is diagnosed with subclinical hypothyroidism due to a TSH of 7 and a normal free T4. Her TPO antibody status is negative. What is the most likely reason for her difficulty in losing weight?
A 48-year-old woman with a 6-year history of type 2 diabetes
mellitus is referred for a second opinion regarding her
unexplained high hemoglobin A1c level. She has been treated
with basal plus mealtime insulin for 3 years. She performs selfmonitoring
of blood glucose 6 to 8 times daily, with values
ranging between 75 and 120 mg/dL (4.2-6.7 mmol/L) before
meals and between 110 and 130 mg/dL (6.1-7.2 mmol/L) 2
hours after meals. She reports rare hypoglycemic episodes.
Her review of systems is notable for recent fatigue and
lightheadedness. Her medications include aspirin and ramipril.
For years, her hemoglobin A1c level has been in the range of
6.5% to 6.9% (48-52 mmol/mol), but 4 months ago it was 7.8%
(62 mmol/mol) and a recent value was 8.5% (69 mmol/mol).
Laboratory test results:
• Hemoglobin = 8.9 g/dL (12.1-15.1 g/dL)
(SI: 89 g/L [121-151 g/L])
• Serum creatinine = 0.8 mg/dL (0.6-1.1 mg/dL)
(SI: 70.7 μmol/L [53.0-97.2 μmol/L])
• Liver function, normal
• TSH, normal
• Urine albumin-to-creatinine ratio = 205 mg/g creat (<30 mg/g creat)
Which of the following is the most likely
cause of her high hemoglobin A1c?
A 31-year-old man with a 16-year history of type 1 diabetes
mellitus complicated by nephropathy and retinopathy is referred
for help achieving better glycemic control. His regimen consists
of insulin degludec, 18 units at bedtime, and insulin lispro with
meals using an insulin-to-carbohydrate ratio of 1:12. He
performs self-monitoring of blood glucose 4 times daily, with
values ranging between 200 and 300 mg/dL (11.1-16.7 mmol/L).
His hemoglobin A1c level has been between 8.5% and 10.0%
(69-86 mmol/mol). His medications include lisinopril,
rosuvastatin, and biotin.
Laboratory test results:
• Hemoglobin A1c = 9.0% (4.0%-5.6%)
(75 mmol/mol [20-38 mmol/mol])
• Serum creatinine = 2.2 mg/dL (0.7-1.3 mg/dL)
(SI: 194.5 μmol/L [61.9-114.9 μmol/L])
• Urine albumin-to-creatinine ratio = 3886 mg/g creat (<30 mg/g creat)
• Liver function, normal
• TSH = 7.5 mIU/L (0.5-5.0 mIU/L)
• Serum fructosamine = 210 μmol/L (200-285 μmol/L)
The discrepancy between this patient’s
hemoglobin A1c and fructosamine levels
is most likely caused by which of the
following?
A 42-year-old man with a 22-year history of type 1 diabetes
mellitus is seeing you for a follow-up visit. He has had poor
glycemic control over the past few years while on insulin pump
therapy. He is reluctant to increase his pump settings because of
the potential for weight gain. He has tried metformin and
pramlintide in the past, but he could not tolerate the
gastrointestinal adverse effects. His hemoglobin A1c value is
now 7.8% (62 mmol/mol), and his BMI is 27 kg/m2.
His basic metabolic panel, liver function, and TSH level are
normal. You suggest off-label use of empagliflozin to lower his
hemoglobin A1c and reduce his weight. He asks about potential
adverse effects.
You tell him that empagliflozin could increase his risk of which of the following?
A 32-year-old woman with type 1 diabetes mellitus is 6 weeks’
pregnant. Her most recent hemoglobin A1c value is 6.9% (52
mmol/mol). She is taking insulin detemir, 8 units in the morning
and 12 units in the evening, in addition to prandial doses of insulin
aspart based on an insulin-to-carbohydrate ratio of 1:10 and a
sensitivity (or correction) factor of 1:40. Her overnight (3 AM) and
fasting blood glucose levels range between 110 and 122 mg/dL
(6.1-6.8 mmol/L), and her peak (1-hour) postprandial glucose
levels range between 112 and 129 mg/dL (6.2-7.2 mmol/L).
Which of the following should you
recommend during this pregnancy?
A 35-year-old man has a 15-year history of type 1 diabetes
mellitus complicated by nonproliferative diabetic retinopathy. He is
concerned about renal complications of diabetes. His most recent
hemoglobin A1c level is 7.8% (62 mmol/mol) on insulin glargine
and mealtime insulin aspart.
Two separate measurements of his urine albumin-to-creatinine
ratio are 20 and 12 mg/g creat. His estimated glomerular filtration
rate is 82 mL/min per 1.73 m2 (>60 mL/min per 1.73 m2).
On physical examination, his blood pressure is 128/72 mm Hg
and BMI is 24 kg/m2.
Which of the following is the most effective
approach to reduce future risk of clinically
significant diabetic nephropathy in this
patient?
A 19-year-old man presents for continued management of
diabetes mellitus, having “aged-out” of pediatric endocrine care.
Diabetes was diagnosed at age 16 years when glycosuria and
moderate hyperglycemia were documented on a yearly checkup.
Insulin therapy was started immediately. His current insulin dose
is approximately 0.3 units/kg per day, administered as multiple
daily injections, and his current hemoglobin A1c level is 6.4% (46
mmol/mol) with occasional hypoglycemia. His family history is
positive for diabetes in his mother, maternal grandfather, and an
older sibling, all diagnosed at age 19 years or younger. His BMI
is 23 kg/m2.
Tests for glutamic acid decarboxylase antibodies, islet-cell
antibodies, insulinoma-associated protein 2 antibodies, and
ZnT8 antibodies are negative; he did not have antibody testing
at the time of diagnosis. His serum C-peptide concentration is
1.1 ng/mL (0.4 nmol/L).
Which of the following is the optimal
management of this patient’s diabetes
Category: Board Review Endocrinology
Which of the following is true regarding the risk of cardiovascular disease (CVD) in patients with diabetes?
The risk of cardiovascular disease (CVD) in patients with diabetes is increased regardless of type and is higher in patients without known CHD than patients with CHD.
Category: Board Review Endocrinology
What is the leading cause of death in patients with type 1 diabetes?
Diabetes is a powerful risk factor for the future development of cardiovascular disease, and this risk is higher in patients with type 1 diabetes after 10 years of duration.
Category: Board Review Endocrinology
What is the age at which transition to high cardiovascular risk occurs in men and women with diabetes?
Age and duration of diabetes play a role in the risk for developing cardiovascular disease, and patients with type 2 diabetes are considered to be at high risk for coronary heart disease.
Category: Board Review Endocrinology
Which of the following is true regarding the effects of diabetes on bone?
The bone effects of diabetes are complex and involve alterations in bone metabolism and structure.
Category: Board Review Endocrinology
In patients with type 1 diabetes, which of the following is associated with an increased risk of fractures?
None
Category: Board Review Endocrinology
What is the relationship between bone mineral density (BMD) and fracture risk in patients with diabetes?
None
Category: Board Review Endocrinology
Which of the following is NOT a potential factor contributing to increased bone fragility in diabetes?
None
Category: Board Review Endocrinology
What is the effect of diabetes on bone health?
Category: Board Review Endocrinology
Which of the following factors is known to be a risk factor for fractures in patients with diabetes?
Category: Board Review Endocrinology
What is the effect of thiazolidinediones on bone health in patients with diabetes?
Category: Board Review Endocrinology
What is the role of bone mineral density (BMD) in assessing fracture risk in patients with diabetes?
Category: Board Review Endocrinology
What should be the first step in the management of bone health in patients with diabetes?
Category: Board Review Endocrinology
What are the typical microbiological spectrum of diabetic foot infections?
The microbiology of diabetic foot wounds is variable depending on the extent of involvement. Superficial diabetic foot infections are likely due to aerobic gram-positive cocci, while deep, chronically infected, and/or previously treated with antibiotics are more likely to be polymicrobial. Wounds with extensive local inflammation, necrosis, malodorous drainage, or gangrene with signs of systemic toxicity should be presumed to have anaerobic organisms in addition to the above pathogens.
Category: Board Review Endocrinology
What is the role of anaerobes in diabetic foot infections?
The role of anaerobes in diabetic foot infections remains unclear. Some studies have found a high prevalence of anaerobes in samples taken from diabetic foot infections, particularly infections that are associated with malodorous drainage or are necrotic, deep, or severe. Whether the anaerobic organisms are truly pathogens remains unclear. Empiric antibiotic regimens for moderate to severe infections include anaerobic coverage.
Category: Board Review Endocrinology
A 65-year-old patient with diabetes presents with a foot ulcer. Which of the following clinical findings increases the likelihood of osteomyelitis in this patient?
The correct answer is associated with a higher risk of osteomyelitis.
Category: Board Review Endocrinology
Which imaging modality is highly sensitive and specific for osteomyelitis and superior to radiographs, three-phase bone scans, and white blood cell scans?
The correct imaging modality provides high sensitivity and specificity for osteomyelitis.
Category: Board Review Endocrinology
Which of the following is NOT sufficient to make the diagnosis of infection in a diabetic foot wound?
The correct answer is related to the presence of bacteria.
Category: Board Review Endocrinology
Which of the following inflammatory markers can be useful for monitoring response to therapy in diabetic foot infections?
The correct answer is an inflammatory marker.
Category: Board Review Endocrinology
Which of the following is the preferred method for removing callus and nonviable tissue in diabetic foot infections?
This method involves using a scalpel or scissors to shear off necrotic tissue.
Category: Board Review Endocrinology
In the management of diabetic foot infections, the purpose of wound dressing is to:
Wound dressing helps in the healing process by maintaining a certain type of environment for the wound.
Category: Board Review Endocrinology
Which of the following is NOT a reason for hospitalization in patients with mild or moderate diabetic foot infections?
Hospitalization may be needed when the patient is unable to manage certain aspects of their care at home.
Category: Board Review Endocrinology
Which type of clinical specimens is preferred for reliable culture in the case of diabetic foot infections?
This method of sample collection is more reliable in predicting the pathogens responsible for deeper infections.
Category: Board Review Endocrinology
In the setting of osteomyelitis, which is the preferred method of sample collection for culture?
This method provides a more accurate representation of the pathogens involved in the infection.
Category: Board Review Endocrinology
A patient with a mild diabetic foot infection should initially receive outpatient oral antimicrobial therapy targeting which microorganisms?
Consider which microorganisms are commonly found in skin flora.
Category: Board Review Endocrinology
In the case of moderate diabetic foot infection, which microorganisms should empiric therapy cover?
Moderate infections involve deeper ulcers extending to the fascia.
Category: Board Review Endocrinology
Severe diabetic foot infections require which type of antibiotic therapy?
Severe infections are limb-threatening or associated with systemic toxicity.
Category: Board Review Endocrinology
In cases of diabetic foot osteomyelitis, what is the ideal source for culture and sensitivity results to guide antimicrobial therapy?
Osteomyelitis involves bone infection.
Category: Board Review Endocrinology
Which adjunctive therapy has been shown to achieve complete ulcer closure more often in patients with diabetic foot ulcers?
none
Category: Board Review Endocrinology
Which of the following is NOT a gastrointestinal manifestation of diabetic autonomic neuropathy (DAN)?
Gastrointestinal manifestations of DAN are related to problems in the stomach and intestines.
Category: Board Review Endocrinology
What is the primary treatment for diabetic gastroparesis?
The primary treatment for diabetic gastroparesis focuses on managing symptoms and improving gastric motility.
Category: Board Review Endocrinology
What percentage of females with type 1 diabetes reported urinary incontinence at the 10-year follow-up time point after completion of the Diabetes Control and Complications Trial (DCCT)?
The correct answer is a percentage greater than 30%.
Category: Board Review Endocrinology
What is the first-line therapy for erectile dysfunction in patients with diabetes?
The first-line therapy for erectile dysfunction in patients with diabetes is a type of medication.
Category: Board Review Endocrinology
When should screening for diabetic autonomic neuropathy (DAN) begin for patients with type 2 diabetes?
Screening for DAN should begin as early as possible for patients with type 2 diabetes.
Category: Board Review Endocrinology
What is the primary cause of diabetic gastroparesis?
Consider the role of the nervous system in controlling gastric function.
Category: Board Review Endocrinology
How does acute hyperglycemia affect gastric emptying?
Think about the relationship between high blood sugar levels and gastric emptying.
Category: Board Review Endocrinology
What is the primary diagnostic tool for establishing the presence of gastroparesis?
This diagnostic tool specifically measures the rate of gastric emptying.
Category: Board Review Endocrinology
Which of the following is NOT a primary treatment for diabetic gastroparesis?
Think about treatments that directly target gastric function and blood sugar control
Category: Board Review Endocrinology
A 65-year-old patient with a history of long-term diabetes presents with chronic diarrhea. Which of the following factors is NOT a potential underlying mechanism for diabetic diarrhea?
Consider the mechanisms that contribute to diarrhea in diabetic patients.
Category: Board Review Endocrinology
In patients with diabetic enteropathy, the diarrhea is usually characterized by:
Think about the typical presentation of diarrhea in diabetic enteropathy.
Category: Board Review Endocrinology
Which of the following medications used in patients with diabetes mellitus can cause diarrhea?
Consider the side effects of common diabetic medications.
Category: Board Review Endocrinology
Which of the following conditions is NOT part of the differential diagnosis for diabetic enteropathy?
Consider other causes of chronic watery diarrhea.
Category: Board Review Endocrinology
What is an appropriate symptomatic treatment for diabetic diarrhea?
Think about the medications that can help manage diarrhea symptoms.
Category: Board Review Endocrinology
Which of the following autoantibodies is not associated with Type 1A diabetes?
Recall the autoantibodies associated with Type 1A diabetes.
Category: Board Review Endocrinology
What is the primary characteristic of Latent Autoimmune Diabetes in Adults (LADA)?
Remember the unique characteristic of LADA.
Category: Board Review Endocrinology
Which of the following is a common genetic feature shared between LADA and Type 2 diabetes?
Think about the genetic similarities between LADA and Type 2 diabetes.
Category: Board Review Endocrinology
What is the primary cause of Type 1B diabetes?
Recall the cause of Type 1B diabetes.
Category: Board Review Endocrinology
Which of the following situations can lead to diabetic ketoacidosis (DKA) in patients with Type 2 diabetes?
Consider the specific situations that can provoke DKA in Type 2 diabetes.
Category: Board Review Endocrinology
A 38-year-old patient presents with unintentional weight loss, subtherapeutic response to metformin, and no history of overweight or obesity. Which of the following tests should be considered to clarify the diagnosis?
Consider the patient's presentation and when islet autoantibody testing is recommended.
Category: Board Review Endocrinology
Which of the following factors is NOT a criterion for considering antibody testing in adult patients with newly diagnosed diabetes?
Think about the factors that increase the likelihood of autoimmune diabetes.
Category: Board Review Endocrinology
Which of the following diabetes-associated autoantibodies should NOT be measured for diagnostic purposes if the patient has received insulin therapy for ≥2 weeks?
Consider which autoantibodies may be affected by insulin therapy.
Category: Board Review Endocrinology
Which of the following conditions is considered a slowly progressive variant of type 1 diabetes?
Consider the conditions with a similar pathophysiology to type 1 diabetes.
Category: Board Review Endocrinology
Which genetic polymorphisms have the largest effect on the risk of developing type 1A diabetes?
Look for the genetic variants with the largest effect on type 1A diabetes risk.
Category: Board Review Endocrinology
What is the most common form of monogenic diabetes, accounting for 2 to 5 percent of diabetes cases?
Look for the most common form of monogenic diabetes.
Category: Board Review Endocrinology
Which gene mutation is most commonly identified in MODY cases, occurring in 52 to 65 percent of cases?
Look for the gene mutation most commonly identified in MODY cases.
Category: Board Review Endocrinology
In patients with a GCK gene mutation, what is the primary treatment for their diabetes?
Look for the primary treatment for diabetes in patients with a GCK gene mutation.
Category: Board Review Endocrinology
Which gene mutation is associated with a syndrome that includes early-onset diabetes, pancreatic atrophy, abnormal renal development, hypomagnesemia, and genital abnormalities?
Category: Board Review Endocrinology
Which of the following characteristics might indicate a high suspicion of monogenic diabetes?
Consider the family history and autoantibodies.
Category: Board Review Endocrinology
What is the recommended treatment for patients with monogenic diabetes due to HNF1A or HNF4A mutations?
Think about the specific genetic mutations and their recommended treatments.
Category: Board Review Endocrinology
Which of the following is a characteristic of maternally inherited diabetes and deafness (MIDD)?
Consider the specific symptoms associated with MIDD.
Category: Board Review Endocrinology
Wolfram syndrome is associated with which of the following manifestations?
Consider the symptoms and age of onset in Wolfram syndrome.
Category: Board Review Endocrinology
Fulminant diabetes is characterized by which of the following?
None
Category: Board Review Endocrinology
A 45-year-old male patient presents with a history of chronic pancreatitis. Which of the following statements regarding glucose intolerance and diabetes in this patient is most accurate?
Consider the relationship between chronic pancreatitis and the development of glucose intolerance and diabetes.
Category: Board Review Endocrinology
Which disease shares features with both type 1 and type 2 diabetes and involves decreased insulin production and insulin resistance?
Think about a disease that affects both insulin production and insulin resistance.
Category: Board Review Endocrinology
Which endocrine abnormality is NOT typically associated with overt diabetes but can interfere with glucose metabolism?
Consider an endocrine abnormality that affects glucose metabolism but does not typically cause overt diabetes.
Category: Board Review Endocrinology
Which of the following viral infections has been associated with an increased incidence of diabetes, but it is uncertain if there is a cause-and-effect relationship?
Consider a viral infection that is associated with diabetes but has an uncertain cause-and-effect relationship.
Category: Board Review Endocrinology
A 42-year-old female patient presents with increased thirst, frequent urination, and blurry vision. A random blood glucose test shows a value of 210 mg/dL (11.7 mmol/L). What is the most likely diagnosis for this patient?
Consider the patient's age and the symptoms she is presenting with.
Category: Board Review Endocrinology
According to the American Diabetes Association (ADA) criteria, what fasting plasma glucose (FPG) range is considered to indicate impaired fasting glucose (IFG)?
IFG is a state of prediabetes.
Category: Board Review Endocrinology
A 28-year-old pregnant woman undergoes a 75 g oral glucose tolerance test (OGTT). Her two-hour plasma glucose value is 195 mg/dL (10.8 mmol/L). What is the most likely diagnosis for this patient?
Consider the patient's pregnancy status and the results of the OGTT.
Category: Board Review Endocrinology
In the diagnostic criteria for diabetes, which of the following A1C values is considered to be diagnostic for diabetes mellitus?
Category: Board Review Endocrinology
A 45-year-old male with a family history of type 2 diabetes comes to your clinic for a routine checkup. He reports being asymptomatic. You decide to run some tests. Which diagnostic test would be most convenient for diagnosing diabetes in this patient?
Look for the diagnostic test that doesn't require fasting or special preparation.
Category: Board Review Endocrinology
Which of the following is NOT a criterion to diagnose diabetes in an asymptomatic individual?
Look for the A1C value that is not a criterion for diagnosing diabetes.
Category: Board Review Endocrinology
In which scenario would the diagnosis of diabetes mellitus be easily established?
Consider the scenario with classic symptoms of hyperglycemia and a high random blood glucose value.
Category: Board Review Endocrinology
Which of the following is NOT a goal of medical nutritional therapy for gestational diabetes mellitus (GDM)?
Consider the goals related to glucose control, nutrition, and weight gain.
Category: Board Review Endocrinology
What percentage of patients with GDM can achieve target glucose levels with lifestyle modification alone?
Look for the percentage related to lifestyle modification in GDM patients.
Category: Board Review Endocrinology
What is the minimum recommended daily carbohydrate intake for all pregnant people according to Dietary Reference Intakes (DRI)?
Look for the minimum carbohydrate intake recommended by the DRI.
Category: Board Review Endocrinology
Which of the following dietary interventions has NOT been shown to improve glycemic control in GDM?
Consider dietary interventions that do not affect glycemic control in GDM patients.
Category: Board Review Endocrinology
Which type of snack is recommended at bedtime for patients with GDM to prevent accelerated ketosis overnight?
Think about the type of snack that helps prevent ketosis and maintain fasting glucose levels.
Category: Board Review Endocrinology
What is the recommended duration of moderate-intensity aerobic activity for adults with diabetes?
Consider the duration that provides at least 150 minutes of moderate-intensity aerobic exercise per week.
Category: Board Review Endocrinology
When should patients with gestational diabetes mellitus (GDM) self-monitor their blood glucose levels?
Consider both fasting and postprandial measurements.
Category: Board Review Endocrinology
What are the American Diabetes Association (ADA) and American College of Obstetricians and Gynecologists (ACOG) recommended upper limits for fasting and postprandial blood glucose concentrations in patients with GDM?
Recall the specific glucose level recommendations provided by the American Diabetes Association (ADA) and American College of Obstetricians and Gynecologists (ACOG).
Category: Board Review Endocrinology
What is the primary benefit of exercise that increases muscle mass for patients with diabetes?
Category: Board Review Endocrinology
A pregnant patient with GDM has a majority of postprandial hyperglycemia and fetal abdominal circumference >75th percentile. What is the most appropriate initial insulin regimen for this patient?
Consider the insulin regimen that addresses both fasting and postprandial glucose levels.
Category: Board Review Endocrinology
In patients with GDM, when should pharmacotherapy be initiated?
The initiation of pharmacotherapy depends on the percentage of blood glucose values above target levels during a week.
Category: Board Review Endocrinology
Which of the following oral antihyperglycemic agents has been shown to reduce the risk for macrosomia in randomized trials, compared to insulin?
Consider the oral antihyperglycemic agent with beneficial effects on birth weight and neonatal hypoglycemia.
Category: Board Review Endocrinology
A pregnant patient with gestational diabetes mellitus (GDM) requires insulin therapy. Which rapid-acting insulin analogs have been investigated in pregnancy and demonstrated acceptable safety profiles, minimal transfer across the placenta, and no evidence of teratogenesis?
Consider the rapid-acting insulin analogs that have been investigated in pregnancy and shown to have acceptable safety profiles, minimal transfer across the placenta, and no evidence of teratogenesis.
Category: Board Review Endocrinology
Which long-acting insulin analog is preferred for use in pregnancy due to more extensive studies and the ability to be dosed twice per day predictably?
Think about the long-acting insulin analog that has been studied more extensively in pregnancy and can be dosed twice per day more predictably.
Category: Board Review Endocrinology
When compared with glyburide, metformin has been associated with:
Consider the differences between metformin and glyburide in terms of maternal outcomes.
Category: Board Review Endocrinology
Both metformin and glyburide cross the placenta. What are the fetal levels for metformin and glyburide compared to maternal levels?
Consider the fetal levels of metformin
Category: Board Review Endocrinology
What is the classification system for ketosis-prone diabetes (KPD) that is shown to be the most accurate in predicting long-term insulin dependence 12 months after the index diabetic ketoacidosis (DKA) event?
This system is based on the presence or absence of autoantibodies and the presence or absence of beta cell functional reserve.
Category: Board Review Endocrinology
Which ketosis-prone diabetes (KPD) subgroup is characterized by the presence of autoantibodies and preserved beta cell function?
This subgroup shares clinical characteristics of type 2 diabetes with preserved beta cell functional reserve.
Category: Board Review Endocrinology
Which factor is NOT considered a potential cause of partially reversible beta cell dysfunction in A-ß+ KPD patients?
The other factors are metabolic, genetic, or viral etiologies.
Category: Board Review Endocrinology
What is the term used for a heterogeneous condition characterized by presentation with diabetic ketoacidosis (DKA) in patients who do not fit the typical characteristics of autoimmune type 1 diabetes?
This condition has been previously described with terms such as “atypical diabetes,” “Flatbush diabetes,” “diabetes type 1B,” and “ketosis-prone type 2 diabetes mellitus.”
Category: Board Review Endocrinology
Which ketosis-prone diabetes (KPD) subgroup is characterized by the absence of autoantibodies and preserved beta cell function?
Category: Board Review Endocrinology
A patient presents with ketosis-prone diabetes (KPD) and diabetic ketoacidosis (DKA). What should be the initial treatment for this patient?
Consider the similarities between KPD and type 1 diabetes.
Category: Board Review Endocrinology
Which test is most commonly used to assess beta cell secretory reserve in ketosis-prone diabetes patients?
This test is used to evaluate beta cell function.
Category: Board Review Endocrinology
Which of the following autoantibodies is NOT commonly measured to assess beta cell autoimmunity in ketosis-prone diabetes?
Three autoantibodies are typically measured, and one of the options is not among them.
Category: Board Review Endocrinology
Which of the following KPD subgroups has the highest chance of discontinuing insulin after 12 months of treatment?
Think about the combination of autoimmunity and beta cell function in the subgroups.
Category: Board Review Endocrinology
Which type of diabetes is caused by autoimmune β-cell destruction?
This type of diabetes involves the destruction of β-cells by the immune system.
Category: Board Review Endocrinology
Which type of diabetes is diagnosed in the second or third trimester of pregnancy?
This type of diabetes is specific to pregnant women.
Category: Board Review Endocrinology
What are the hallmark symptoms of type 1 diabetes in children?
These symptoms are related to increased urination and thirst.
Category: Board Review Endocrinology
What does LADA stand for?
This term refers to a slowly progressive autoimmune diabetes that occurs in adults.
Category: Board Review Endocrinology
Which type of diabetes is typically associated with insulin resistance and metabolic syndrome?
This type of diabetes often involves a progressive loss of β-cell insulin secretion and may occur in the background of insulin resistance.
Category: Board Review Endocrinology
Which of the following is NOT a general category of diabetes?
Category: Board Review Endocrinology
Which diagnostic test requires no caloric intake for at least 8 hours before testing?
Consider the test that involves fasting.
Category: Board Review Endocrinology
What is the A1C diagnostic threshold for diabetes?
Category: Board Review Endocrinology
What does LADA stand for?
Recall the term for slowly progressive autoimmune diabetes with an adult onset.
Category: Board Review Endocrinology
Which diagnostic test for diabetes should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay?
Consider the test that involves measuring glycated hemoglobin.
Category: Board Review Endocrinology
Which test should be performed to diagnose diabetes in a patient with classic symptoms of hyperglycemia?
Consider the test that is suitable for patients with classic symptoms of hyperglycemia.
Category: Board Review Endocrinology
What is the A1C diagnostic threshold for diabetes?
Look for the A1C percentage that indicates diabetes.
Category: Board Review Endocrinology
In which conditions should only plasma blood glucose criteria be used to diagnose diabetes?
Consider conditions that impact red blood cell turnover or hemoglobin glycation.
Category: Board Review Endocrinology
Which factor may cause African American individuals to have lower A1C levels for a given level of mean glycemia?
Focus on a common hemoglobin variant found in African American individuals.
Category: Board Review Endocrinology
How many grams of carbohydrates should a person consume daily for at least 3 days prior to oral glucose tolerance testing?
Category: Board Review Endocrinology
At what age should screening for prediabetes and type 2 diabetes begin for all people?
Consider the recommended age for universal screening.
Category: Board Review Endocrinology
Which of the following tests is NOT appropriate for screening for prediabetes and type 2 diabetes?
Review the appropriate tests mentioned in the text for screening prediabetes and type 2 diabetes.
Category: Board Review Endocrinology
What is the minimum recommended interval for repeat screening if the initial tests for prediabetes and type 2 diabetes are normal?
Consider the suggested time interval for retesting when initial tests are normal.
Category: Board Review Endocrinology
What is the recommended carbohydrate intake before an oral glucose tolerance test for diabetes screening?
Look for the amount of carbohydrate intake that should be assured for 3 days prior to testing.
Category: Board Review Endocrinology
When should risk-based screening for prediabetes and/or type 2 diabetes be considered in children and adolescents with overweight or obesity?
Consider when screening should start in relation to puberty and age.
Category: Board Review Endocrinology
What is the definition of prediabetes?
Consider all the factors that can indicate prediabetes.
Category: Board Review Endocrinology
At what age should screening for diabetes begin for all people?
Think about the age mentioned in the text for starting diabetes screening.
Category: Board Review Endocrinology
How often should people with prediabetes be tested for diabetes?
Consider the frequency of testing mentioned in the text for people with prediabetes.
Category: Board Review Endocrinology
What is the ADA Diabetes Risk Test used for?
Think about the purpose of the ADA Diabetes Risk Test mentioned in the text.
Category: Board Review Endocrinology
Which condition is associated with insulin resistance and could be a risk factor for prediabetes?
Category: Board Review Endocrinology
What percentage of all diabetes cases is represented by Type 2 diabetes?
Type 2 diabetes is the most common form of diabetes.
Category: Board Review Endocrinology
Which of the following factors increases the risk of developing type 2 diabetes?
Consider factors like age, obesity, and lack of physical activity.
Category: Board Review Endocrinology
What is a common characteristic of people with type 2 diabetes concerning insulin levels?
Think about the relationship between insulin levels and blood glucose in type 2 diabetes.
Category: Board Review Endocrinology
Which of the following is least likely to occur spontaneously in individuals with type 2 diabetes?
Consider complications that are less common in type 2 diabetes.
Category: Board Review Endocrinology
Which racial/ethnic subgroups have a higher prevalence of type 2 diabetes?
Category: Board Review Endocrinology
At what age should testing for diabetes begin for all people?
Consider the age mentioned for starting diabetes testing.
Category: Board Review Endocrinology
What BMI cut point is suggested for defining increased risk in Asian American individuals?
Recall the specific BMI cut point mentioned for Asian American individuals.
Category: Board Review Endocrinology
Which of the following medications is known to increase the risk of diabetes?
Category: Board Review Endocrinology
What is the recommended screening interval for diabetes in high-risk individuals?
Category: Board Review Endocrinology
Why is community screening for diabetes generally not recommended?
Consider the potential issues with follow-up care in community screening.
Category: Board Review Endocrinology
At what age should annual screening for cystic fibrosis–related diabetes begin?
Consider the age mentioned for starting cystic fibrosis–related diabetes screening.
Category: Board Review Endocrinology
Which test is NOT recommended as a screening test for cystic fibrosis–related diabetes?
Category: Board Review Endocrinology
What is the primary treatment for people with cystic fibrosis–related diabetes?
Category: Board Review Endocrinology
When should annual monitoring for complications of cystic fibrosis–related diabetes begin?
Think about the time frame mentioned for starting annual monitoring for complications.
Category: Board Review Endocrinology
What is the primary rationale for using insulin in people with cystic fibrosis–related diabetes?
Consider the main reason mentioned for using insulin in cystic fibrosis–related diabetes
Category: Board Review Endocrinology
After organ transplantation, what should be screened for?
Consider what condition is mentioned to be screened for after organ transplantation.
Category: Board Review Endocrinology
Which test is preferred to diagnose posttransplantation diabetes mellitus?
Recall the test mentioned as the preferred method for diagnosing posttransplantation diabetes mellitus.
Category: Board Review Endocrinology
What is the primary treatment for hyperglycemia in patients after organ transplantation?
Consider the primary treatment mentioned for hyperglycemia in posttransplant patients.
Category: Board Review Endocrinology
Which factor is NOT a risk factor for posttransplantation diabetes mellitus?
Category: Board Review Endocrinology
What is a common complication in transplant patients that may require drug dose adjustments?
Category: Board Review Endocrinology
At what age should individuals diagnosed with diabetes undergo genetic testing for neonatal diabetes?
Consider the age mentioned for immediate genetic testing for neonatal diabetes.
Category: Board Review Endocrinology
Which type of diabetes is characterized by onset of hyperglycemia at an early age and autosomal dominant pattern of inheritance?
Look for the type of diabetes described with early onset and autosomal dominant pattern of inheritance.
Category: Board Review Endocrinology
Which gene mutation is the most common cause of permanent neonatal diabetes?
Recall the gene mutation mentioned as the most common cause of permanent neonatal diabetes.
Category: Board Review Endocrinology
What is the preferred treatment for individuals with GCK-MODY?
Consider the treatment mentioned for individuals with GCK-MODY.
Category: Board Review Endocrinology
What is the first-line therapy for individuals with HNF1A- or HNF4A-MODY?
Recall the first-line therapy mentioned for individuals with HNF1
Category: Board Review Endocrinology
What is the main reason for correctly diagnosing monogenic diabetes?
Consider the main reason for the correct diagnosis of monogenic diabetes.
Category: Board Review Endocrinology
What can a biomarker screening pathway, such as the combination of urinary C-peptide/creatinine ratio and antibody screening, aid in?
Recall the purpose of the biomarker screening pathway mentioned in the text.
Category: Board Review Endocrinology
What is a distinguishing feature of postpancreatitis diabetes mellitus (PPDM)?
Consider the specific feature mentioned for postpancreatitis diabetes mellitus (PPDM).
Category: Board Review Endocrinology
What term is used to describe hyperglycemia due to general pancreatic dysfunction?
Look for the term used for hyperglycemia caused by general pancreatic dysfunction.
Category: Board Review Endocrinology
What is the primary cause of diabetes in the context of disease of the exocrine pancreas?
Category: Board Review Endocrinology
What is the recommended screening period for gestational diabetes mellitus in pregnant individuals who have not been previously diagnosed with diabetes or high-risk abnormal glucose metabolism?
Category: Board Review Endocrinology
When should individuals with a history of gestational diabetes mellitus be screened for prediabetes or diabetes postpartum?
Find the recommended postpartum screening time for individuals with a history of gestational diabetes mellitus.
Category: Board Review Endocrinology
How often should individuals with a history of gestational diabetes mellitus be screened for the development of diabetes or prediabetes?
Look for the recommended lifelong screening frequency for individuals with a history of gestational diabetes mellitus.
Category: Board Review Endocrinology
What should individuals with a history of gestational diabetes mellitus and diagnosed with prediabetes receive to prevent diabetes?
Find the recommended prevention strategy for individuals with a history of gestational diabetes mellitus and prediabetes.
Category: Board Review Endocrinology
Which of the following tests can be used for early abnormal glucose metabolism screening during pregnancy?
Category: Board Review Endocrinology
When should pregnant individuals be screened for gestational diabetes mellitus (GDM) if they have not been previously diagnosed with diabetes or high-risk abnormal glucose metabolism?
Focus on the standard screening time for GDM.
Category: Board Review Endocrinology
What are the two strategies for diagnosing gestational diabetes mellitus (GDM)?
One strategy is derived from the IADPSG criteria, while the other is an older approach.
Category: Board Review Endocrinology
At which plasma glucose values is the diagnosis of GDM made using the one-step 75-g OGTT strategy?
Remember the specific plasma glucose values for the one-step 75-g OGTT strategy.
Category: Board Review Endocrinology
What is the prevalence of prediabetes in people of reproductive age (20-44 years) according to NHANES data?
Category: Board Review Endocrinology
What is the main difference between the one-step and two-step strategies for diagnosing GDM?
Look for the main tests used in each strategy.
Category: Board Review Endocrinology
What are the main mediators of childhood body fat associated with maternal hyperglycemia during pregnancy according to HAPO FUS data?
Category: Board Review Endocrinology
Which of the following is NOT a recommended site for insulin injection?
Look for the site that is not mentioned as a recommended site for insulin injection.
Category: Board Review Endocrinology
What is the main reason for the importance of injection site rotation in insulin therapy?
Look for the complication that occurs due to repeated insulin injections at the same site.
Category: Board Review Endocrinology
What is the main advantage of using short needles (e.g., 4-mm pen needles) for insulin injection?
Look for the advantage related to the risk of injecting insulin into the wrong tissue.
Category: Board Review Endocrinology
What is the main effect of pramlintide when used as an adjunct to insulin treatment in adults with type 1 diabetes?
Look for the effects of pramlintide on A1C levels and weight.
Category: Board Review Endocrinology
Which medication should be continued upon initiation of insulin therapy for ongoing glycemic and metabolic benefits in type 2 diabetes patients?
Look for the medication that is most commonly prescribed as the first-line treatment for type 2 diabetes.
Category: Board Review Endocrinology
When should the early introduction of insulin be considered in type 2 diabetes treatment?
Look for the circumstances where blood glucose or A1C levels are significantly elevated.
Category: Board Review Endocrinology
In adults with type 2 diabetes, which is preferred over insulin when possible?
Look for the medication class that is preferred over insulin when possible.
Category: Board Review Endocrinology
What should be reevaluated at regular intervals (every 3-6 months) in type 2 diabetes patients?
Look for the aspect of treatment that needs ongoing monitoring and adjustment.
Category: Board Review Endocrinology
Which agent should be continued upon initiation of insulin therapy for ongoing glycemic and metabolic benefits?
This agent is often used as the first-line treatment for type 2 diabetes.
Category: Board Review Endocrinology
In adults with type 2 diabetes, which is preferred over insulin when possible?
This agent mimics the action of the incretin hormone.
Category: Board Review Endocrinology
What should be considered in the glucose-lowering management of type 2 diabetes?
These factors help to create a person-centered approach to diabetes management.
Category: Board Review Endocrinology
When should the early introduction of insulin be considered?
These are indications that the patient may need more aggressive glucose-lowering treatment.
What is the most significant difference between white adipocytes and brown adipocytes?
Consider the unique function of brown adipocytes in producing heat.
Which of the following factors does NOT induce the “beiging” of white adipose tissue (WAT)?
Consider the factors that promote the transformation of white adipose tissue to beige adipose tissue.
Which of the following hormones is NOT a lipolytic inducer and primarily functions to suppress lipolysis in adipocytes?
Think about the role of insulin in regulating lipolysis and its effects on adipocytes.
Which enzyme is directly phosphorylated and activated by protein kinase A (PKA) in the lipolytic process?
Consider the role of PKA in the lipolytic process and the enzymes it directly phosphorylates and activates.
In patients with diabetes and obesity, insulin resistance at the adipocyte level results in excessive lipolysis, leading to what consequence?
Think about the consequences of excessive lipolysis in the context of insulin resistance in patients with diabetes and obesity.
What is the primary role of T-cadherin in adiponectin signaling?
T-cadherin is associated with a specific form of adiponectin.
Which of the following is NOT a known effect of adiponectin in the liver?
Consider adiponectin's role in modulating lipid metabolism.
What is the primary reason thiazolidinediones (TZDs) improve insulin sensitivity and glucose tolerance?
Consider the role of adiponectin in insulin sensitivity and glucose tolerance.
Which of the following medications is associated with weight gain when compared to placebo in the management of diabetes?
Consider the various types of medications used in the management of diabetes and their potential effects on weight.
Which of the following is a mechanism by which sulfonylureas cause weight gain?
Consider how sulfonylureas work to increase insulin levels and how that might impact weight gain.
Which type of β-blocker should be prioritized when treating a population with a high risk for metabolic side effects?
Consider the different types of β-blockers and their effects on glucose and lipid profiles.
Which of the following factors is a strong predictor of long-term weight gain when starting a psychotropic drug therapy?
Consider the factors that could influence weight gain when starting psychotropic drug therapy and which factor has been consistently shown to be a strong predictor.
A 38-year-old female patient with a history of major depressive disorder is concerned about weight gain while on antidepressant therapy. Which of the following antidepressant medications is associated with the least weight gain?
Consider the medication that reduces appetite and food cravings.
Which of the following antipsychotic medications is associated with the highest risk of weight gain?
Consider the medication with the highest affinity for the H1-histaminic receptor.
What is a potential mechanism by which lithium induces weight gain in patients with bipolar disorder?
Consider the effect on appetite regulation.
Which of the following factors is a risk factor for weight gain during lithium therapy for bipolar disorder?
Consider medication interactions.
Which of the following strategies is recommended by the ADA/APA consensus guidelines for patients with more than 5% weight gain or worsening lipid or glycemia parameters due to SGAP treatment?
Consider the ADA/APA consensus guidelines recommendations for patients experiencing weight gain due to SGAP treatment.
Which of the following antiepileptic drugs is associated with weight loss?
Think about the antiepileptic drugs that can lead to weight loss.
How do glucocorticoids affect body fat distribution?
Consider the impact of glucocorticoids on visceral fat mass.
Which of the following drugs is associated with a higher risk for hepatic steatosis but not inflammation or fibrosis?
Consider the drugs that induce liver steatosis without increasing inflammation or fibrosis.
Which of the following is a known risk factor for lipoatrophy in HIV patients on antiretroviral therapy?
Consider the factors that increase the risk of lipoatrophy in HIV patients.
Which of the following antiretroviral drugs is associated with the greatest increase in insulin resistance?
Consider the effects of the nucleoside analogues on insulin resistance.
What is the primary mechanism by which older nucleoside analogues contribute to lipoatrophy?
Consider the effects of older nucleoside analogues on adipocytes and mitochondrial function.
Which of the following treatments is FDA-approved specifically for reducing visceral adiposity in HIV-infected patients with lipodystrophy?
Look for a treatment that targets visceral adiposity specifically and is FDA-approved.
Which of the following anthropometric indices is not used to assess the obesity-related risk of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD)?
Consider which of these indices specifically measures central obesity.
Which of the following factors contribute to the higher cardiometabolic risk associated with central fat distribution?
Think about how the properties of visceral adipose tissue affect insulin sensitivity and inflammation.
Which of the following is not a component of the vicious cycle formed in chronic hyperinsulinemia?
Consider which factors contribute to the worsening of hyperinsulinemia and hyperglycemia.
Which of the following interventions is not beneficial for the prevention of Type 2 Diabetes Mellitus (T2DM)?
Consider which intervention may have potential negative effects on insulin resistance and T2DM risk.
Which factors contribute to the higher cardiometabolic risk associated with central fat distribution in obesity?
Consider the role of visceral adipose tissue and its secretory profile.
Which of the following dietary components has been associated with beneficial effects on blood glucose regulation and body fat distribution in the long-term?
Think about the impact of specific dietary components on insulin sensitivity and risk of developing T2DM.
Which of the following tissues plays a crucial role in overall regulation of glycemia in type 2 diabetes mellitus (T2DM)?
Consider the role of various tissues in regulating blood glucose levels in T2DM.
Which of the following statements is true about the impact of insulin resistance and obesity on the development of type 2 diabetes mellitus (T2DM)?
Consider the factors necessary for the development of T2DM and the role of obesity in the process.
A 42-year-old female with a BMI of 34 presents with central obesity and complains of fatigue. Which of the following mechanisms contributes most significantly to the chronic low-grade inflammatory state observed in obesity?
Focus on the role of adipokines and chemokines in the development of inflammation in obesity.
In a patient with obesity-related metabolic syndrome, which of the following factors is associated with a procoagulant state and increased CVD risk?
Consider the factors involved in the coagulation cascade and their association with CVD risk.
In the context of obesity-related inflammation, which of the following cells can differentiate into macrophages and function as macrophage-like cells?
Think about the cells that share a common ancestral origin from the mesoderm during early embryogenesis.
A 42-year-old male with a history of obesity and T2DM presents with elevated liver enzymes. Liver biopsy reveals steatosis in over 5% of hepatocytes. What is the most likely diagnosis?
Consider the patient's history and the presence of steatosis in hepatocytes.
Which of the following populations has the highest prevalence of non-alcoholic fatty liver disease (NAFLD)?
Consider the ethnic variations documented in NAFLD prevalence.
Which factor is NOT associated with the progression of non-alcoholic fatty liver disease (NAFLD) to non-alcoholic steatohepatitis (NASH)?
Consider the factors that contribute to the progression of NAFLD to NASH.
What is the natural history of NAFLD with simple steatosis without inflammation and fibrosis?
A 45-year-old female patient with obesity and T2DM presents with elevated liver enzymes. What is the most likely diagnosis in this patient?
Consider the patient's risk factors and the prevalence of liver diseases in the general population.
Which of the following ethnic groups is at the highest risk for developing NAFLD?
Consider the ethnic variations in NAFLD prevalence mentioned in the text.
Which stage of NAFLD is associated with the worst prognosis?
Think about the natural history and progression of NAFLD as described in the text.
Which of the following factors is NOT involved in the pathogenesis of NAFLD?
Review the factors mentioned in the text that are involved in the pathogenesis of NAFLD.
In the context of obesity, what is the primary function of leptin?
Consider leptin's role in maintaining energy balance.
Which adipocytokine is preferentially produced by visceral adipose tissue and has insulin-sensitizing actions?
Focus on adipocytokines produced by visceral adipose tissue.
What is the proposed classification of obesity based on leptin secretion and action?
Consider obesity classifications related to leptin.
How are adiponectin levels associated with obesity and insulin resistance?
Think about the relationship between adiponectin levels and metabolic abnormalities.
A 45-year-old male with a history of T2D and obesity underwent RYGB surgery 6 months ago. He has lost significant weight and his glycemic control has improved. Which of the following medication adjustments is most appropriate for this patient?
Consider the effects of bariatric surgery on glycemic control and the role of metformin in managing diabetes.
Which of the following bariatric surgery procedures is associated with the highest rate of diabetes remission?
Review the diabetes remission rates for different bariatric surgery procedures.
A 55-year-old female with a history of hypertension and obesity underwent LAGB surgery 1 year ago. She has lost significant weight and her blood pressure has improved. Which of the following is the most appropriate management for her hypertension?
Consider the effects of bariatric surgery on blood pressure and the guidelines for managing hypertension after surgery.
Which of the following long-term complications is NOT associated with bariatric surgery?
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To fulfill this, we aim to adhere as strictly as possible to the World Wide Web Consortium’s (W3C) Web Content Accessibility Guidelines 2.1 (WCAG 2.1) at the AA level. These guidelines explain how to make web content accessible to people with a wide array of disabilities. Complying with those guidelines helps us ensure that the website is accessible to all people: blind people, people with motor impairments, visual impairment, cognitive disabilities, and more.
This website utilizes various technologies that are meant to make it as accessible as possible at all times. We utilize an accessibility interface that allows persons with specific disabilities to adjust the website’s UI (user interface) and design it to their personal needs.
Additionally, the website utilizes an AI-based application that runs in the background and optimizes its accessibility level constantly. This application remediates the website’s HTML, adapts Its functionality and behavior for screen-readers used by the blind users, and for keyboard functions used by individuals with motor impairments.
If you’ve found a malfunction or have ideas for improvement, we’ll be happy to hear from you. You can reach out to the website’s operators by using the following email admin@myendoconsult.com
Our website implements the ARIA attributes (Accessible Rich Internet Applications) technique, alongside various different behavioral changes, to ensure blind users visiting with screen-readers are able to read, comprehend, and enjoy the website’s functions. As soon as a user with a screen-reader enters your site, they immediately receive a prompt to enter the Screen-Reader Profile so they can browse and operate your site effectively. Here’s how our website covers some of the most important screen-reader requirements, alongside console screenshots of code examples:
Screen-reader optimization: we run a background process that learns the website’s components from top to bottom, to ensure ongoing compliance even when updating the website. In this process, we provide screen-readers with meaningful data using the ARIA set of attributes. For example, we provide accurate form labels; descriptions for actionable icons (social media icons, search icons, cart icons, etc.); validation guidance for form inputs; element roles such as buttons, menus, modal dialogues (popups), and others. Additionally, the background process scans all of the website’s images and provides an accurate and meaningful image-object-recognition-based description as an ALT (alternate text) tag for images that are not described. It will also extract texts that are embedded within the image, using an OCR (optical character recognition) technology. To turn on screen-reader adjustments at any time, users need only to press the Alt+1 keyboard combination. Screen-reader users also get automatic announcements to turn the Screen-reader mode on as soon as they enter the website.
These adjustments are compatible with all popular screen readers, including JAWS and NVDA.
Keyboard navigation optimization: The background process also adjusts the website’s HTML, and adds various behaviors using JavaScript code to make the website operable by the keyboard. This includes the ability to navigate the website using the Tab and Shift+Tab keys, operate dropdowns with the arrow keys, close them with Esc, trigger buttons and links using the Enter key, navigate between radio and checkbox elements using the arrow keys, and fill them in with the Spacebar or Enter key.Additionally, keyboard users will find quick-navigation and content-skip menus, available at any time by clicking Alt+1, or as the first elements of the site while navigating with the keyboard. The background process also handles triggered popups by moving the keyboard focus towards them as soon as they appear, and not allow the focus drift outside of it.
Users can also use shortcuts such as “M” (menus), “H” (headings), “F” (forms), “B” (buttons), and “G” (graphics) to jump to specific elements.
We aim to support the widest array of browsers and assistive technologies as possible, so our users can choose the best fitting tools for them, with as few limitations as possible. Therefore, we have worked very hard to be able to support all major systems that comprise over 95% of the user market share including Google Chrome, Mozilla Firefox, Apple Safari, Opera and Microsoft Edge, JAWS and NVDA (screen readers), both for Windows and for MAC users.
Despite our very best efforts to allow anybody to adjust the website to their needs, there may still be pages or sections that are not fully accessible, are in the process of becoming accessible, or are lacking an adequate technological solution to make them accessible. Still, we are continually improving our accessibility, adding, updating and improving its options and features, and developing and adopting new technologies. All this is meant to reach the optimal level of accessibility, following technological advancements. For any assistance, please reach out to admin@myendoconsult.com