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218 Cards in this Set

  • Front
  • Back
True/False
Both the liver and the muscle have the ability to store excess glucose as glycogen and have both the ability to break down this stored glucose and present it to the blood for use by other tissues.
False. and only the liver has the ability
True/False
For glucose to stimulate insulin release at the beta cell of the pancreas, it must first enter the cell via a Glut 2 transporter and then be phosphorylated by the hexokinase enzyme.
False. glucokinase
List the 4 principal secretory products by the endocrine pancreas: (in any order)
_________, ________, ________ and __________.
Insulin, glucagon, somatostatin, amylin,or C-peptide
True/False
For glucose to stimulate insulin release at the beta cell of the pancreas, it must first enter the cell via a Glut 4 transporter and then be phosphorylated by the glucokinase enzyme.
False. Glut 2
True/False
Insulin is required for the uptake of glucose in an exercising muscle.
False. is not
True/False
GLP-1 enhances insulin secretion and inhibits glucagon secretion.
True
True/False
Similar blood glucose values are obtained following an oral ingestion of glucose and an intravenous (iv.) injection of glucose (true statement). Insulin secretion is different with these two routes of glucose administration, with the iv. route producing a greater stimulation of insulin.
False. oral route producing
________________ is an enzyme from the liver, which is important in regard to glucose metabolism, that is activated by both vagal stimulation and insulin.
Glycogen synthetase
True/False
At concentrations of around 50 mg/dl, glucose is a potent stimulator of insulin release. It enters the beta cells of the pancreas via a Glut 2 transporter and must be phosphorylated by hexokinase to be effective in stimulating insulin release.
False. glucokinase
True/False
Glycerol is the major substrate for gluconeogenesis.
False. Lactate
Measurement of ___________ in the blood is the best indicator of the function of the beta cells of the pancreas.
C-peptide
Which of the following is FALSE with regards to the actions of insulin?
a. Increases the synthesis and activity of the Glut 4 transporter in the muscle and adipocyte.
b. Effects the transmembrane potential of the cell, thereby increasing the influx of magnesium, potassium and phosphate.
c. Increases the uptake of glucose in the liver by its actions on the glucokinase enzyme.
d. Mediates much of its action at the cell through its activation of cAMP.
e. None of the above are false
d. Mediates much of its action at the cell through its activation of cAMP.
Anabolism (Insulin) decreases cAMP
Catabolism (glucagon) increases cAMP
True/False
A diagnostic criteria for diabetes mellitus is a plasma glucose value > to 200 mg% in the 2nd hour of an oral glucose tolerance test.
True
True/False
Generally speaking diabetes mellitus is a disease characterized by a relative or absolute insulin deficiency coupled with an abnormal secretion of glucagon.
True
True/False
Nearly 75% of all deaths from diabetes are cardiovascular related.
True
The ABC's for the management of diabetes stands for (a) __________, (b) ______________, and (c) ________________.
a. A1c glycated hemoglobin
b. blood pressure
c. cholesterol
Which of the following is/are TRUE with regard to the acute metabolic complications of diabetes?
a. Infections and trauma are predisposing factors for the development of ketoacidosis.
b. Symptoms of dry mouth, kussmaul respiration and acetone breathe are common in patients with hyperosmolar hyperglycemic nonketotic comma.
c. In diabetic patients, hypoglycemia can result from excess alcohol ingestion.
d. Insulin dosage has to be increased before exercise to avoid hyperglycemia.
e. all of the above are true
f. Only a and c are true
f. Only a and c are true
DCCT is an abbreviation for:
a. Don't Care Can't Think
b. Diabetic Combination Control Trial
c. Diabetes Couples Can’t Touch
d. Diabetics Can't Control Things
e. Diabetic Complication Control Trial
f. Diabetics Can’t Couple Together
e. Diabetic Complication Control Trial
Plasma glucose of 110 mg/dl is equivalent to about _______ mg/dl of blood glucose.
100
A diagnostic criteria for diabetes mellitus is a fasting plasma glucose equal to or above __________________ .
126 mg/dl or 126 mg%
Chronic hyperglycemia can result in an increase in the polyol pathway, which can result in an abnormal elevation of ______________ in the cell. {Not water or enzymes}
Sorbitol or fructose
Which of the following is/are TRUE statement(s)?
a. Often type 2 diabetic patients are not diagnosed with the disease until they present with some of the complications attributed to the disease.
b. Patients with impaired glucose tolerance are are at increased risk for microvascular complications.
c. It is current common practice that all pregnant women are given a routine GTT (glucose tolerance test) at the time of pregnancy to diagnose GDM.
d. The majority of all diabetic patients have auto-antibodies to components of the beta cell of the pancreas.
e. All of the above are true
a. Often type 2 diabetic patients are not diagnosed with the disease until they present with some of the complications attributed to the disease.
Which of the following is/are TRUE with regard to acute metabolic complications of diabetes?
a. Infections and trauma are predisposing factors for the development of ketoacidosis.
b. Symptoms of dry mouth, kussmaul respiration and acetone breathe are common is patients with hyperosmolar hyperglycemic nonketotic comma.
c. Hypoglycemia can result from excess alcohol ingestion.
d. Insulin dosage has to be increased before exercise to avoid hyperglycemia.
e. Only a and c are true
e. Only a and c are true
True/False
Every 1 % of glycated HbA1c is equal to about 30 mg/dl of plasma glucose.
True
True/False
Diabetic women who are pregnant are at increased risk for the development of ketoacidosis in the late stages of pregnancy.
True
True/False
Macroangiopathy complications are the most common cause of morbidity and mortality in Type 2 diabetics.
True
True/False
Every 1 % of glycated HbA1c is equal to about 60 mg/dl of plasma glucose.
False. 30 mg/dl
True/False
Diabetic women who are pregnant are at increased risk for the development of ketoacidosis in the early stages of pregnancy.
False. late stages
True/False
It has been clearly demonstrated that diabetics who smoke and are hypertensive are at an increased risk for the development of retinopathy.
False. nephropathy
True/False
Macroangiopathy complications can result from endothelial dysfunction, such as an elevation of endothelin and/or a decrease in NO.
True
True/False
Insulin is considered an anabolic hormone. Its release can stimulate enzymes for gluconeogenesis.
False. glycogenesis
True/False
A current diagnostic criterion for diabetes is fasting blood glucose of 126 mg/dl.
False. plasma glucose
True/False
Diabetes is strongly associated with an autoimmune pathogenesis. The DR3 and DR4 HLA haplotypes are found in about 95 % of patients with Type 2 diabetes.
False. Type 1
True/False
The paracrine effect of insulin on the delta cells of the pancreas can result in an increase of somatostatin release.
False. decrease
True/False
Of the three acute metabolic complications discussed, ketoacidosis has the highest mortality.
False. Hyperglycemic Hyperosmolar Nonketotic coma has
Name the pancreatic hormone that causes a decrease in hepatic cAMP levels and results in a decrease in the breakdown of glycogen. ________________.
insulin
____________ is elevated in obesity and has been shown to reduce the levels of Glut 4 transporters.
TNF-alpha
True/False
Glucagon is considered a catabolic hormone. Its release can result in lipolysis, ketogenesis and glycogenolysis.
True
True/False
The paracrine effect of glucagon on beta cells can result in the increase in secretion of insulin.
True
True/False
A current diagnostic criterion for diabetes is fasting plasma glucose of 126 mg/dl.
True
True/False
Diabetes is strongly associated with an autoimmune pathogenesis. The DR2 and DR5 HLA haplotypes are found in about 95 % of patients with Type 1 diabetes.
False. DR3 and DR4
True/False
Elderly Type 2 diabetic patients with renal failure are at the most risk of developing ketoacidosis.
developing HHNK.
TNF-alpha is elevated in obesity and has been shown to reduce the levels of ____________.
Glut 4
True/False
In order for glucose to stimulate insulin release it must first enter the pancreatic cell via a Glut 2 transporter and then be phosphorylated by the hexokinase enzyme.
False. glucokinase
Amylin is synthesized in the _______ cell of the pancreas.
Beta
The best assessment of pancreatic beta cell function is the measurement of __________________.
C-peptide
List two hormones that are secreted from the beta-cell of the pancreas: ________ and ________.
Amylin and Insulin
Which of the following signaling events occur after activation of the insulin receptor:
a. decrease intracellular calcium
b. decrease in Na/K ATPase activity
c. increased cAMP levels
d. tyrosine kinase activation
e. all of the above are not even in the body
d. tyrosine kinase activation
Which of the following enzyme is not stimulated by insulin.
a. glucokinase
b. pyruvate kinase
c. glycogen synthetase
d. glucose-6-phosphatase
e. glycerol kinase
d. glucose-6-phosphatase
True/False
The most common cause of morbidity and mortality of type 2 diabetics is related to macrovascular complications.
True
True/False
The leading cause of death due to an acute metabolic complication in type 1 diabetics is ketoacidosis.
True
True/False
Chronic hyperglycemia can result in an increase in the polyol pathway, which results in abnormal elevation of sorbitol and fructose in the cell.
True
True/False
Neuropathy is one manifestation of microangiopathy in which the earliest signs of the disease are proteinuria and hypertension.
False. Nephropathy
Which of the following statements describes the relationship between exercise and blood glucose type 1 diabetic patients:
a. Physical exercise is contraindicated in people with diabetes.
b. Insulin dosage has to be increased before exercise to avoid hyperglycemia.
c. Exercise interferes with the peripheral utilization of insulin.
d. Exercise facilitates the uptake of glucose into the muscle cells.
d. Exercise facilitates the uptake of glucose into the muscle cells.
Babies born of diabetic mothers may be at greater risk to be:
a. of short stature
b. excessively large and prone to respiratory distress
c. premature and of low birth weights
d. excessively edematous and hyperglyclemic
b. excessively large and prone to respiratory distress
True/False
A single fasting plasma glucose test revealing a plasma glucose level greater than 126 mg/dl is sufficient evidence for an absolute diagnosis of diabetes.
False. More than one fasting glucose test
True/False
Patients having DR3 and DR4 alleles (haplotypes) on the HLA chromosome are more genetically susceptible for the development of type 1 diabetes.
True
True/False
Only glucose and vagus stimulation can result in insulin release.
False. Glucose, vagus, amino acids, ketone bodies, FFA, glucagon, and GI hormones can
In pancreatic islet cells, calcium influx will increase/decrease release of insulin and increase/decrease release of glucagon.
increase
decrease
Approximately 60% of the glucose available between meals is utilized by __________ tissue; whereas approximately 60% of glucose available during meals is utilized by the _____________.
Neural
Liver
True/False
The action of insulin on enhancing protein synthesis in the cell is directly dependent on the transport of amino acids into the cell.
False. is independent
True/False
During exercise, the uptake of glucose by muscle is mediated through Glut 4 transporters, which are sensitive to insulin.
True
True/False
Vagal stimulation will increase the activity of glycogen synthetase enzyme in the liver as well as the release of insulin from the beta cells of the pancreas.
True
True/False
Insulin is considered an anabolic hormone. Its release can stimulate enzymes for gluconeogenesis.
can inhibit enzymes for gluconeogenesis.
True/False
Glucose-6-phosphatase is the key enzyme found in the liver and kidney that facilitates the process of gluconeogenesis.
True
True/False
Glycerol is the major substrate for gluconeogenesis.
False. Lactate
True/False
In between meals glucose levels are maintained by the breakdown of glycogen to glucose by liver and muscle.
by the liver only.
True/False
Examples of stimulators of insulin release are: amino acids, free fatty acids, glucagon and stimulation of the sympathetic nervous system.
False. of the parasympathetic
True/False
Insulin mediates much of its action at the target cell through its activation of tyrosine kinase.
True
True/False
Diabetes can be defined as a metabolic syndrome that is associated with premature and progressive vascular abnormalities, such as micro and macrovascular disease.
True
True/False
Normal pregnancy is a diabetogenic-like condition where women have a state of insulin resistance and an elevation of plasma insulin. Therefore, any pregnant women will be diagnosed with Gestational Diabetes.
False. Not all pregnant women will
True/False
Measurement of insulin in the blood is the best indicator of the function of the beta cells of the pancreas.
False. C-peptide
True/False
Diabetes Mellitus is a metabolic and endocrine disorder that can be characterized by a relative or absolute decrease of insulin and usually is associated with an elevation of amylin.
elevation of plasma glucose.
True/False
Elderly individuals with type II diabetes, especially those with renal failure, are at high risk to develop an acute metabolic complication of diabetes called hyperosmolar hyperglycemic nonketotic coma, which is characterized by hypovolemia, dehydration, weakness, and coma.
True
True/False
The hypoglycemic effects of alcohol are delayed by several hours and are more pronounced if alcohol is consumed without food.
True
Which of the following is TRUE with regard to insulin and lipid metabolism?
a. NADPH is a cofactor needed for the synthesis of lipids. Its levels are increased by the actions of insulin.
b. Glycerol is a substrate for TG synthesis and its formation is stimulated by actions of insulin on the alpha glycerol phosphate enzyme.
c. Most of the fatty acid synthesis takes place in the liver.
d. Insulin helps promote fat storage at the adipocyte by increasing the action of lipoprotein lipase.
e. All of the above are true.
e. All of the above are true.
Which of the following is TRUE in regards to somatostatin?
a. Stimulates glucagon and insulin secretion by the pancreas
b. Is stimulated by amino acids in the blood
c. Its release is decreased by acetylcholine
d. Impairs the uptake of calcium in the pancreatic beta cells
e. b, c and d are true
e. b, c and d are true
Which of the following statements is NOT true with regards to glucagon?
a. Stimulates the activity of gluconeogenic enzymes.
b. Has an insignificant action on muscle, unless insulin is absent.
c. Stimulates lipolysis in the adipocyte.
d. Inhibits insulin and somatostatin release.
d. Inhibits insulin and somatostatin release.
Which of the following are NOT the current diagnostic criteria for diabetes mellitus?
a. A two hour OGGT that exceeds 200 mg %
b. A fasting plasma sample that exceeds 126 mg%
c. A random blood sample that exceeds 200 mg% combined with the classic polytriad of symptoms
d. A fasting plasma glucose that exceeds 140 mg%.
d. A fasting plasma glucose that exceeds 140 mg%.
Type I diabetes mellitus is characterized by which of the following?
a. Patients are generally asymptomatic.
b. The majority of patients have autoantibodies to the pancreatic islet cells (and/ or their products) before the development of symptoms
c. Incidence is more common in Hispanics and Blacks than in Caucasians.
d. There is a very strong association with the Major Histocompatibility Complex in diabetes in that individuals with DR2 and DR5 halotypes are more genetically susceptible to develop Type I diabetes.
e. b and d are correct
b. The majority of patients have autoantibodies to the pancreatic islet cells (and/ or their products) before the development of symptoms
Which of the following is/are TRUE for type 2 diabetic patients?
a. The concordance rate between twins approximates 50 %.
b. It is strongly associated with the HLA-d region of the major histocompatability leukocytic antigen complex found on chromosome 6.
c. It is characterized by a sudden onset of severe hyperglycemia.
d. Normally do not develop ketoacidosis.
e. a, b, and c are correct
d. Normally do not develop ketoacidosis.
Diabetes is a disorder of metabolism or heterogeneous etiology. Which of the following statements is/are TRUE concerning diabetes?
a. There is a relative or absolute deficiency of insulin.
b. Disorder normally accompanied by an increase in the levels of counter regulatory hormones such as cortisol.
c. There is an abnormally high secretion of glucagon that can be restored with insulin therapy.
d. The majority of diabetic patients have auto-antibodies to components of the beta cell of the pancreas.
e. Only a, b and c are true statements.
e. Only a, b and c are true statements.
Which of the following is a FALSE statement for type 2 diabetes?
a. Characterized by a fasting hyperglycemia and marked impaired glucose intolerance.
b. Often patients are not diagnosed with the disease until they present with some of the complications attributed to the disease.
c. The major complications associated with this disease are microvascular.
d. Obesity and age are the major risk factors.
c. The major complications associated with this disease are microvascular.
(macrovascular)
Which of the following statements is/are plausible reasons for the development of hyperglycemia in type 2 diabetes?
a. There is an increase in glucose production, both via gluconeogenesis and glycogenolysis.
b. The beta cells can become desensitized and/or exhausted due to a glucotoxicity.
c. There can be a decrease in both Glut 2 and Glut 4 transporters
d. The increased mobilization of FFA can inhibit glucose utilization.
e. All the above are plausible reasons.
e. All the above are plausible reasons.
Which of the following is/are TRUE statement(s) with regard to impaired glucose tolerance?
a. Diagnosed with a postprandial blood glucose of over 140 mg %
b. Diagnosed with a fasting plasma glucose >100 but < 126 mg%.
c. Patients are at increased risk for microvascular complications
d. May be considered “pre-diabetes” since ~ 5-7% of these patients convert to Type 2 diabetes yearly.
e. Only b and c are correct.
e. Only b and c are correct.
Which of the following statements is/are TRUE?
a. Twenty to fifty percent of women with GDM can develop type 2 diabetes within 5-10 years after childbirth.
b. All women are given a routine GTT at the time of pregnancy to diagnose GDM.
c. Children born of women with GDM have a 300 X increased risk to develop diabetes.
d. Gestational diabetes occurs in about 20 % of all pregnancies.
e. Only a and c are correct.
a. Twenty to fifty percent of women with GDM can develop type 2 diabetes within 5-10 years after childbirth.
In regard to the ABC’s of diabetes, which of the following statements is/are TRUE?
a. A majority of diabetic patients know the significance of the ABC’s.
b. Over 70% of diabetic patients are either on antihypertensive agents or have a BP in excess of 130/80 mm Hg.
c. The target for HDL in diabetic patient is <40 mg %
d. Cholesterol and glycated hemoglobin testing should be done every other year in diabetic patients.
e. Only b and c are true
b. Over 70% of diabetic patients are either on antihypertensive agents or have a BP in excess of 130/80 mm Hg.
A twenty-four year old Type 1 diabetic female is found in a dazed and confused state. She has tachycardia and cold clammy skin. Which of the following is the likely etiology of her condition?
a. Peripheral neuropathy
b. Hypoglycemia
c. Renal failure
d. Hyperglycemia
b. Hypoglycemia
Which of the following statements describes the relationship between exercise and type I diabetes?
a. Physical exercise is contraindicated in people with diabetes
b. Insulin dosage has to be increased before exercise to avoid hyperglycemia
c. Exercise interferes with the peripheral utilization of insulin
d. Insulin is not required to facilitate the transport of glucose into exercising muscle.
d. Insulin is not required to facilitate the transport of glucose into exercising muscle.
Which of the following is FALSE with regard to diabetic ketoacidosis?
a. Infections and trauma are predisposing factors
b. Results when a lack of insulin is coupled with an increase in the output of counterregulatory hormones
c. Symptoms are dry mouth, kussmaul respiration and acetone breath.
d. Can result from excess alcohol ingestion
d. Can result from excess alcohol ingestion
A 55-year-old obese patient is admitted into a medical unit after the final 4 basketball game. He is complaining of a blister on his foot that has not healed. He says it looks “dark and ugly”. He indicated that he did not even realize the blister was there until he removed his shoe and found it was bloody. He states that he is also feeling poorly, with some chest pain. His serum glucose was 280 mg/dl and his serum cholesterol was 250 mg/dl. This patient is most likely experiencing which of the following complications of diabetes mellitus?
a. Diabetic neuropathy, infection, macrovascular disease
b. Nephropathy, coronary artery disease, infection
c Infection, microvascular disease, nephropathy
d. Retinopathy, infection, microvascular disease
a. Diabetic neuropathy, infection, macrovascular disease
Mr. Jones is a 45-yr. old man who presents with a 2 month history of fatigue and excessive thirst. He is a new patient to your practice. Relevant history includes possible borderline hypertension and obesity. He is a 1-2 pack a day smoker and family history is significant for premature CAD, hypertension and diabetes. His initial exam is relatively normal and BP is 135/82 mmHg. Fasting Glucose is 138 mg/dl. Other results include a total cholesterol 215, HDL-C 31 mg/dl.
A week later he returns and his fasting glucose is 167 mg/dl. Subsequent HbA1c is 7.1% When he comes to the office to discuss his results you tell him he has diabetes and refer him for diabetes education and nutritional counseling.
In a 1 year follow-up office visit for his annual diabetes evaluation, having lost 30 lbs in weight, adhering to a diet and exercise plan, home glucose monitoring reveals fasting glucose readings in the 130-150mg/dl range and HbA1c of 7.0%. Exam is normal, BP 128/75mmHg. You would now:
a. Refer him for a dilated retinal exam.
b. Obtain urine for assessment of proteinuria.
c. Strongly encourage him to stop smoking.
d. Assess lower extremities for evidence of foot deformity, ulcers and sensory abnormalities.
e. All of the above.
e. All of the above.
Which of the following is TRUE concerning Diabetic women who become pregnant:
a. If hypertensive, they should be on ACE inhibitors to control blood pressure.
b. They are at increased risk for hypoglycemia in the later stages of pregnancy.
c. Poorly controlled diabetic women may have children born in respiratory distress due to a decrease in surfactant.
d. The incidence of the development of NTD can be reduced with folic acid to a similar degree as in non-diabetic pregnant women.
c. Poorly controlled diabetic women may have children born in respiratory distress due to a decrease in surfactant.
As a teenager M.M.was diagnosed with type 1 diabetes. Although there were many difficulties in the early years she now does well controlling her diabetes. She finished high school, attends college, and finds employment. She continues to seek health care appropriately. She has a routine physical examination at the age of 26. M.M. is informed that she has some renal dysfunction. The first manifestation of renal dysfunction for M.M. is most likely:
a. Development of the nephrotic syndrome
b. Increase in serum creatine levels
c. Albuminuria
d. Decrease in blood urea nitrogen levels
c. Albuminuria
Which of the following is/are usually considered a possible pathology for the development of diabetic neuropathy:
a. Elevated sorbitol pathway
b. Glycation of proteins
c. Microangiopathy
d. a, b and c are correct
e. a, and c are correct
d. a, b and c are correct
Chronic hyperglycemia can result in the formation of advanced glycated end (AGE) products, which in turn can have other biochemical and structural effects that can play a central role in the pathogenesis of chronic complications in diabetes. Which of the following statements does NOT describe some of these effects?
a. AGE's can interact with the endothelium to increase the development of atherosclerosis by elevating the levels of nitric oxide and decreasing the levels of endothelin.
b. AGE’s can bind to hemoglobin resulting in an increased affinity to oxygen and decreased oxygen to tissues
c. AGE’s can affect matrix and basement membrane proteins.
d. AGE’s can interact with macrophages resulting in the release of cytokines.
a. AGE's can interact with the endothelium to increase the development of atherosclerosis by elevating the levels of nitric oxide and decreasing the levels of endothelin.
A primary finding of the DCCT was:
a. Intensive treatment of patients with Type 1 diabetes was associated with a decrease in the risk of developing long term complications of diabetes, such as neuropathy and retinopathy.
b. Type 2 diabetes is best controlled with diet and exercise and can often be prevented in high risk individuals
c. Many of the long-term complications are not greatly affected by increasing the frequency of blood glucose monitoring.
d. Tight glycemic control in patients with Type 1 diabetes reduces the macrovascular complications by > 70 %.
e. ACE inhibitors should be utilized in every patient with diabetes because of their renoprotective effects.
a. Intensive treatment of patients with Type 1 diabetes was associated with a decrease in the risk of developing long term complications of diabetes, such as neuropathy and retinopathy.
True/False
Most diabetic patients are aware that cardiovascular diseases are the major cause of morbidity and mortality in diabetes.
False. are not aware
True/False
The Km of the Glut 2 transporters is higher than that of the Glut 3 transporter.
True
True/False
The metabolism of glucose in the beta cells of the pancreas results in a closure of the ATPase-sensitive potassium channels, which then allows for the entry of calcium and subsequent release of insulin.
True
Which of the following has/have been identified as possible physiological effects of amylin?
a. Amylin reduced postprandial glucagon secretion
b. Results from clinical trials suggest that the actions of amylin on glucagon secretion are mediated centrally.
c. Amylin’s suppression of glucagon secretion is overridden by hypoglycemia.
d. Amylin administration in diabetics may reduce body weight
e. All of the above are true
e. All of the above are true
True/False
In a patient with Type 1 diabetes treatment with insulin alone is better than combined treatment with both somatostatin and insulin.
False. combined treatment with both somatostatin and insulin is better than insulin alone.
True/False
Most diabetic patients are aware that cardiovascular disease complications are the major cause of morbidity and mortality in diabetes.
False. are not aware
True/False
The amount of insulin secreted is based on the amount of glucose presented to the beta cells of the pancreas, regardless of the manner in which the glucose enters the system.
False. depending on the manner (oral vs. IV route)
True/False
Insulin binds to its receptor and mediates much of its action at the cell through the activation of protein kinase C.
False. tyrosine kinase
True/False
The incidence of Type 2 diabetes is more common in Caucasians and Asians compared to Native Americans and Hispanics.
False. Native Americans and Hispanics compared to Caucasians and Asians.
True/False
Infants of women with Gestational Diabetes are more prone to hypoglycemia at birth.
True
True/False
It appears that the adipose tissue of obese patients may produce a substance, possibly TNFalpha, which depresses the synthesis of Glut 4 transporters.
True
True/False
Nonproliferative retinopathy, the most severe stage of retinopathy, results in hemorrhages, and proliferation of vessels that can lead to blindness in the patient.
False. Proliferative retinopathy
True/False
Calcium influx is required for the release of insulin from the beta cells and glucagon from the alpha cells of the pancreas.
False. from the beta cells only.
True/False
Approximately 60 % of the glucose absorbed after a meal is taken up by the liver by the action of insulin on Glut 4 transporters.
False. Glut 2
True/False
Somatostatin release is stimulated by a hypoglycemic state.
False. hyperglycemic
True/False
The concordance rate in Type 1 diabetes is nearly 100%.
False. under 50%.
True/False
Plasma glucose of 110 mg/dl is equivalent to a blood glucose of about 100 mg/dl.
True
True/False
The risk of developing a hypoglycemic complication in diabetes is greater in patients that have an autonomic neuropathy.
True
True/False
Vagal stimulation will increase the activity of the glycogen synthetase enzyme in the liver.
True
True/False
When insulin binds to its receptor, the levels of cAMP within the target cell are elevated.
False. decreased.
True/False
Insulin release is dependent on closing the ATP sensitive potassium channels.
True
True/False
Glycerol is the major substrate for gluconeogenesis.
False. Lactate
True/False
Glucose-6 phosphate is the enzyme found in the liver and muscle that facilitates the of glycogenolysis.
False. only in the liver
True/False
The most common cause of morbidity and mortality of Type II diabetics is related to macrovascular complications.
True
Which of the following statements is FALSE regarding the release and secretion of insulin in the human:
a. Agents that decrease cAMP will inhibit insulin secretion.
b. The pancreas can store 4 to 8 day supply of insulin.
c. Secretion can be inhibited by somatostatin and facilitated by glucagon.
d. Secretion of insulin is inhibited by vagus stimulation.
d. Secretion of insulin is inhibited by vagus stimulation.
Which of the following statements is FALSE:
a. Mineralocorticoids and glucocorticoids are bound to albumin and/or CBG (transcortin) in
order to be transported in the blood.
b. The major hormone regulator of the Zona Glomerulosa is ACTH and the major hormone
regulator of the Zona Fasiculata is angiotensin II,
c. Angiotensin II can increase the activity of the side chain cleavage enzyme.
d. The enzyme that is confined to the Zona Glomerulosa of the adrenal gland is 18 hydroxylase.
b. The major hormone regulator of the Zona Glomerulosa is ACTH and the major hormone
Which of the following is FALSE with regard to pancreatic beta cell secretions:
a. Amylin is released and has an effect on the brain to reduce food intake.
b. In both Type I and Type 2 diabetes, amylin secretion is reduced.
c. Amylin stimulates the release of glucagon.
d. Insulin release is dependent on the metabolism of glucose in pancreatic Beta cells.
c. Amylin stimulates the release of glucagon.
Which of the following is TRUE with regard to insulin and lipid metabolism:
a. NADPH is a cofactor needed for the synthesis of lipids. It is increased by actions of insulin.
b. Glycerol's direct entry into the adipocyte is facilitated by membrane actions of insulin.
c. Most of the fatty acid synthesis takes place in the adipocyte.
d. Insulin helps promote fat storage in the adipocyte by increasing the action of hormone sensitive lipase.
a. NADPH is a cofactor needed for the synthesis of lipids. It is increased by actions of insulin.
Which of the following is FALSE with regard to diabetic ketoacidosis:
a. Infections and trauma are predisposing factors.
b. Results when a lack of insulin is coupled with an increase in the output of counterregutatory
hormones.
c. Symptoms of dry mouth, kussmaul respiration and acetone breathe.
d. Can result from excess alcohol ingestion.
d. Can result from excess alcohol ingestion.
Symptoms of hypoglycemia that are related to the adrenergic reaction to the low blood glucose are which of the following:
a. Tachycardia.
b. Hypothermia
c. Skin Pallor.
d. Coma.
e. a and c
e. a and c
Which of the following is NOT considered a possible pathology for the development of diabetic neuropathy:
a. Elevated sorbitol pathway.
b. Glycation of proteins.
c. Increase in the myoinositol system.
d. Microangiopathy.
c. Increase in the myoinositol system.
Which of the following is a FALSE statement about microangiopathy.
a. Vascular complications of diabetes mellitus that involves small vessels.
b. Chronic hyperglycemia results in an abnormal thickening of basement membrane.
c. Neuropathy is the most common type of microangiopathy.
d. The clinical manifestations of microangiopathy that occur in patients with Type I or Type II diabetes occur at the same frequency as it does in individuals with impaired glucose tolerance.
d. The clinical manifestations of microangiopathy that occur in patients with Type I or Type II diabetes occur at the same frequency as it does in individuals with impaired glucose tolerance.
Which of the following statements is TRUE with respect the Diabetes Control and Complications Trial:
a. This multicentered clinical trial was conducted for about a ten year period in Type 2 diabetic patients.
b. The results of the study concluded that tight control of blood glucose can significantly reduce
the incidence of nephropathy, retinopathy and neuropathy in Type 1 diabetic patients.
c. DCCT stands for Diabetics Can't Control Things.
d. This clinical trial demonstrated that tight control of blood glucose is ideal for all diabetic
patients and has no adverse effects on the patient.
b. The results of the study concluded that tight control of blood glucose can significantly reduce
the incidence of nephropathy, retinopathy and neuropathy in Type 1 diabetic patients.
Chronic hyperglycemia can result in the formation of advanced glycated end (AGE) products which in turn can have other biochemical and structural effects that can playa central role in the pathogenesis of chronic complications in diabetes. Which of the following statements is FALSE.
a. AGE's can react with the endothelium of the vasculature to increase the release of endothelin
and reduce the release of EDRF (nitric oxide).
b. AGE's can react with red blood cells to release cytokines.
c. AGE's can interact with the endothelium to increase the development of atherosclerosis.
d. AGE's can effect matrix and basement membrane proteins.
b. AGE's can react with red blood cells to release cytokines.
Orlando does well controlling his diabetes. He finishes high school, attends college, and finds employment. He continues to seek health care appropriately. He has a routine physical examination at the age of 26. Orlando is informed that he has some renal dysfunction. The first manifestation of renal dysfunction for Orlando is most likely:
a. Development of the nephrotic syndrome.
b. Increase in serum creatinine levels.
c. Proteinuria.
d. Decrease in blood urea nitrogen levels.
c. Proteinuria.
BJ is a 55 year old, obese patient. She is admitted to the medical unit complaining of a blister on her foot that has not healed. She says it looks "dark and ugly." She indicates she did not even realize the blister was there until she removed her shoe and found it was bloody. She states she has been feeling poorly with some chest pains. BJ is most likely experiencing which of the following complications of diabetes?
a. Diabetic neuropathy.
b. Infection.
c. Macroangiopathy.
d. Microangiopathy.
e. All of the above.
e. All of the above.
Which of the following conditions would result in the hyperglycemic state associated with diabetes:
a. Decreases in the number or effectiveness of GLUT 4 transporters in the pancreas.
b. Reductions in the number or effectiveness of GLUT 4 transporters in the liver.
c. A reduction in the number or effectiveness of GLUT 4 transporters in the adipocyte and/or muscle.
d. Increases in the number or effectiveness of GLUT 2 transporters in the pancreas.
c. A reduction in the number or effectiveness of GLUT 4 transporters in the adipocyte and/or muscle.
Which of the following is NOT a correct statement with regards to Type 1 diabetes
a. A genetically determined autoimmune disease.
b. 70-85% of the patients have autoantibodies to the pancreatic islet cells even before the
development of symptoms.
c. Incidence is more common in Caucasians than non-Caucasians.
d. There is a very strong association with the Major Histocompatibility Complex in that individuals
with DR2 and DR5 haplotypes are more genetically susceptible to develop Type I diabetes.
d. There is a very strong association with the Major Histocompatibility Complex in that individuals
with DR2 and DR5 haplotypes are more genetically susceptible to develop Type I diabetes.
Diabetes mellitus is a genetically and clinically heterogeneous group of disorders of metabolism, which can be manifested by:
a. Increase in carbohydrate tolerance.
b. Decrease in glucagon secretion by the alpha cells of the islets of Langerhans.
c. lncrease in the number of insulin receptors in the periphery.
d. Absolute or functional insulin deficiency.
c. lncrease in the number of insulin receptors in the periphery.
The individual with Type 1 diabetes usually has all the following signs and symptoms EXCEPT:
a. Weight gain.
b. Polydipsia.
c. Polyuria.
d. Fatigue.
e. Polyphagia.
a. Weight gain.
Which of the following statements would describe how a hyperglycemic state could occur in Type II diabetes mellitus.
a. Diabetic patients can have an increased secretion of glucagon.
b. There can be an impaired pancreatic response to glucose resulting in increased insulin release.
c. There may be an increase in the sensitivity of the liver to insulin's suppressive effects on glucose production.
d. Glucose production is increased and glucose utilization decreased.
e. A and D are true
e. A and D are true
Match the following enzymes with the hormone that INCREASES their activity.
Hormone sensitive lipase
a. insulin
b. glucagon
c. neither insulin or glucagon
b. glucagon
Match the following enzymes with the hormone that INCREASES their activity.
Glucokinase
a. insulin
b. glucagon
c. neither insulin or glucagon
a. insulin
Match the following enzymes with the hormone that INCREASES their activity.
Glycogen synthetase
a. insulin
b. glucagon
c. neither insulin or glucagon
a. insulin
Match the following enzymes with the hormone that INCREASES their activity.
Phosphorylase
a. insulin
b. glucagon
c. neither insulin or glucagon
b. glucagon
Match the following enzymes with the hormone that INCREASES their activity.
Glycerol kinase
a. insulin
b. glucagon
c. neither insulin or glucagon
a. insulin
Match the following enzymes with the hormone that INCREASES their activity.
Gluconeogenic enzymes
a. insulin
b. glucagon
c. neither insulin or glucagon
b. glucagon
Match the following enzymes with the hormone that INCREASES their activity.
Acetyl-CoA-carboxylase
a. insulin
b. glucagon
c. neither insulin or glucagon
a. insulin
Match the following enzymes with the hormone that INCREASES their activity.
Lipoprotein lipase
a. insulin
b. glucagon
c. neither insulin or glucagon
a. insulin
The normal range for fasting plasma sugar is _____________.
80-100 mg %
A diagnostic criterion for diabetes mellitus is fasting plasma glucose equal to or above __________
126 mg %
The therapeutic target for blood pressure in diabetic patients is _______ and the target for LDL is __________
130/80 & 100 mg/dl
Alcohol can induce a hypoglycemic crisis in diabetic patients by reducing ________________.
gluconeogenesis
True/False
Approximately 60% of the basal or resting blood glucose is utilized by the liver.
False. neural tissue.
True/False
Both the liver and muscle have the ability to store glucose as glycogen and provide glucose through glycogenolysis.
False. Only the liver has
True/False
Amino acids are the major substrate for gluconeogenesis.
False. Lactate is
True/False
During fasting, glycogenolysis is responsible for about 25% of glucose entering the blood while gluconeogenesis is responsible for the remaining 75%.
False. 75%... 25%
True/False
Vagal stimulation will increase the activity of the glycogen synthetase enzyme in the liver.
True
True/False
For glucose to stimulate insulin release at the beta cell of the pancreas it must first enter the cell via a Glut 2 transporter and then be phosphorylated by the glucokinase enzyme.
True
True/False
Insulin is released in a biphasic manner and the first phase is dependent on closing the ATP sensitive potassium channels.
True
True/False
Stimulators of insulin release are amino acids, free fatty acids, glucagon, and stimulation of the sympathetic nervous system.
False. parasympathetic nervous system.
True/False
Insulin increases the action of hormone sensitive lipase enzyme in the adipocyte cell.
False. decreases
True/False
Insulin release is needed for the uptake of glucose into the exercising muscle.
False. is not needed
True/False
Calcium influx is required for the release of insulin from the beta cells and glucagon from the alpha cells of the pancreas.
False. from the beta cells only.
True/False
In a patient with Type 1 diabetes, treatment with insulin alone would be better than combining the insulin treatment with either somatostatin and/or amylin.
False. would be worse than
True/False
During a meal consisting of protein and carbohydrates, both insulin and glucagon can be released from the beta and alpha cells of the pancreas respectively.
True
True/False
Diabetes Mellitus is a metabolic and endocrine disorder that can be characterized by a relative or absolute decrease of insulin and usually is associated with an elevated of glucagon.
True
True/False
Increased mobilization of FFA inhibits glucose utilization.
True
True/False
Plasma glucose of 100 mg/dl is equivalent to a blood glucose of about 110 mg/dl.
False. 110 mg/dl... 100 mg/dl
True/False
Heart attacks occur about 2.5 times more frequently in patients with diabetes mellitus as in normal individuals of comparable age.
True
True/False
In diabetic patients, the therapeutic target for blood pressure is 130/90 mmHg and the target for LDL is less than 100 mg/dl.
False. 130/80
True/False
Every 1% of GHbA1c is equal to about 30 mg/dl of glucose.
True
True/False
The majority of patients with diabetes do not realize that they are at increased risk for the development of CV diseases.
True
Which of the following is False in regards to somatostatin?
a. Inhibits glucagon and insulin secretion by the pancreas
b. Is stimulated by amino acids in the blood
c. Inhibits gastric motility
d. Is stimulated by hypoglycemia
d. Is stimulated by hypoglycemia
Which of the following are considered physiological actions of amylin
a. Has an effect on the brain to reduce food intake
b. Reduction of postprandial glucagon secretion
c. Regulates the rate of gastric emptying and therefore the delivery of nutrients into the small intestine
d. Most of the effects of amylin are locally mediated at or near the pancreas.
e. a, b, and c are correct
e. a, b, and c are correct
Which of the following is False in regards to the actions of insulin?
a. Mediates much of its action at the cell through its activation of cAMP
b. Effects the transmembrane potential of the cell, thereby increasing the influx of magnesium, potassium and phosphate
c. Increases the uptake of glucose in the liver by its actions on the glucokinase enzyme
d. Increases the synthesis and activity of the Glut 4 transporter in the muscle and adipocyte
a. Mediates much of its action at the cell through its activation of cAMP
Which of the following statements are True about glucose transporters?
a. Of all the glucose transporters, Glut 3 has the lowest Km
b. Expression of Glut 2 are most likely elevated in Type 1 diabetes
c. Glut 4 transporters are mainly found in muscle and liver
d. Glut 3 transporters operate best when glucose is at physiological levels observed after a meal.
e. All of the above are true
a. Of all the glucose transporters, Glut 3 has the lowest Km
Which of the following statements is True with regard to insulin and lipid metabolism?
a. NADPH is a cofactor needed for the synthesis of lipids. It is increased by actions of insulin.
b. Glycerol's direct entry into the adipocyte is facilitated by membrane actions of insulin.
c. Insulin helps promote fat storage in the adipocyte by increasing the action of lipoprotein lipase.
d. Most of the fatty acid synthesis takes place in the adipocyte
e. A and C are correct
e. A and C are correct
Which of the following statements is/are True with regards to glucagon?
a. Stimulates the activity of gluconeogenic enzymes
b. Stimulates the activity of hormone sensitive lipoprotein lipase
c. Inhibits glucokinase enzyme
d. Stimulates insulin and somatostatin release
e. All of the above are true
e. All of the above are true
What is the current cutoff for impaired fasting glucose for the diagnosis of prediabetes?
a. A postprandial blood glucose of over 180 mg/dl
b. A postprandial blood glucose of over 140 mg/dl
c. A fasting plasma glucose of over 110 mg/dl and below 126 mg/dl
d.A fasting plasma glucose of over 126 mg/dl
e. A fasting plasma glucose of over 100 mg/dl and below 126 mg/dl
e. A fasting plasma glucose of over 100 mg/dl and below 126 mg/dl
Which of the following is FALSE concerning Diabetic women who become pregnant:
a. If hypertensive, they should be on ACE inhibitors to control blood pressure.
b. They are at increased risk for hypoglycemia in the early stages of pregnancy.
c. They are at increased risk of the development of ketoacidosis in the late stages of pregnancy.
d. The incidence of congenital abnormalities varies directly with the severity of maternal hyperglycermia
a. If hypertensive, they should be on ACE inhibitors to control blood pressure.
Which of the following statements about Type 2 diabetes is FALSE?
a. Type 2 diabetes is the most common form of diabetes.
b. Type 2 diabetes is characterized by a rapid weight loss.
c. Most patients with Type 2 diabetes are obese.
d. The onset of Type 2 diabetes is often insidious.
e. Patients with Type 2 diabetes are not at risk to develop ketoacidosis.
b. Type 2 diabetes is characterized by a rapid weight loss.
Which of the following is a False statement?
a. Twenty to fifty percent of women with GDM can develop type 2 diabetes within 5-10 years after childbirth.
b. In type 2 diabetes the first phase of insulin release is suppressed.
c. About 50% of the US population over the age of 65 are either IGT or diabetic.
d. Individuals who are diagnosed as Impaired Glucose Tolerant (IGT) are considered increased risk for microvascular and neuropathetic complications.
e. None of the above
e. None of the above
Type 1 diabetes is characterized by all of the following except:
a. Genetically determined autoimmune disease
b. 70-85% of the patients have autoantibodies to the pancreatic islet cells even before the development of symptoms
c. Incidence is more common in non-Caucasians than Caucasians.
d. There is a very strong association with the Major Histocompatability Complex in diabetes in that individuals with DR3 and DR4 halotypes are more genetically susceptible to Type 1 Diabetes
c. Incidence is more common in non-Caucasians than Caucasians.
Which of the following statements is true with respect to Type 2 diabetes?
a. There is a strong genetic influence. The concordance rate approaches 50%.
b. There is a higher incidence of this type of diabetes during the cold and flu seasons
c. Eighty to ninety percent of the beta pancreatic islet cells are destroyed before a significant hyperglycemia is apparent.
d. Sixty to eightly percent of the patients are obese.
d. Sixty to eightly percent of the patients are obese.
Which of the following conditions could result in the hyperglycemia state associated with diabetes?
a. A decrease in glucagon release
b. A reduction in the number of effectiveness of Glut 4 transporters in the liver
c. A reduction in the number of effectiveness of Glut 4 transporters in the adipocyte and/or muscle
d. An increase in the number or effectiveness of Glut 4 transporters in the pancreas
c. A reduction in the number of effectiveness of Glut 4 transporters in the adipocyte and/or muscle
Which of the following conditions is NOT associated with a precipitation of a hypoglycemic state in a diabetic patient.
a. Overdose of insulin or oral hypoglycemia agents
b. Strenuous exercise
c. Excess alcohol ingestion
d. Chronic infections
d. Chronic infections
Which of the following is NOT usually considered a possible pathology for the development of diabetic neuropathy
a. Elevated sorbitol pathway
b. Glycation of proteins
c. Increase in the myoinositol system
d. Microangiopathy
c. Increase in the myoinositol system
Chronic hyperglycemia can result in the formation of advanced glycated end (AGE) products, which in turn can have other biochemical and structural effects that can play a central role in the pathogenesis of chronic complications in diabetes. Which of the following statements does NOT describe some of these effects?
a. AGE's can interact with the endothelium to increase the development of atherosclerosis b. Alterations in signal transduction pathways such as the myoinositol pathway
c. AGE’s can affect matrix and basement membrane proteins.
d. AGE’s can interact with red blood cells resulting in the release of cytokines.
d. AGE’s can interact with red blood cells resulting in the release of cytokines.
MM has been taught to regulate her insulin pump according to her needs and does this very well. She will most appropriately decrease the rate of insulin injection:
a. Before meals
b. When she has a cold
c. Before cheerleading practice
d. While studying for school exams
c. Before cheerleading practice
MM regulates her insulin successfully for several weeks. One day at school she notices she is having trouble concentrating, and has blurred vision. She notes that she has neglected to readjust her insulin pump after giving herself a bolus of insulin at breakfast. MM's symptoms are most likely a result of:
a. Neurological malnutrition
b. Adrenergic reaction
c. Hyperosmolar hyperglycemic nonketotic coma
d. Diabetic ketoacidosis
a. Neurological malnutrition
MM becomes ill with the flu. Because she is not eating properly, she discontinues her insulin regiment for several days. She begins to feel weaker and more lethargic. She voids frequently and notes the presense of acetone in her urine. Her blood glucose by finger is 450 mg%. She is then diagnosed with diabetic ketoacidosis most likely because:
a. Is experiencing a tremendous growth spurt
b. Has not eaten for several days
c. Has insufficient amounts of both insulin and stress hormone
d. Has an absolute deficiency of insulin with an increase in stress hormones
d. Has an absolute deficiency of insulin with an increase in stress hormones
The first manifestation of renal dysfunction is most likely:
a. Development of nephrotic syndrome
b. Increase in serum creatinine levels
c. Proteinuria
Decrease in blood urea nitrogen levels
c. Proteinuria
True/False
During exercise (in normal individuals) glucose uptake in the muscle is increased and insulin secretion is inhibited.
True
True/False
Individuals who are diagnosed as Impaired Glucose Tolerant (IGT) are at increased risk for microvascular complications.
True
True/False
Infants of women with Gestational Diabetes are more prone to hypoglycemia at birth.
True
True/False
Overdose of insulin or oral hypoglycemic agents, strenuous exercise, chronic infections, and excess alcohol ingestion are all factors that can precipitate a hypoglycemic state in a diabetic state.
False. (not chronic infections)
True/False
During exercise (in normal individuals) glucose uptake in the muscle is increased as is insulin secretion.
False. decreased
True/False
Individuals who are diagnosed as Impaired Glucose Tolerant (IGT) are at increased risk for macrovascular complications.
True
True/False
Overdose of insulin or oral hypoglycemic agents, strenuous exercise, and excess alcohol ingestion are all factors that can precipitate a hypoglycemic state in a diabetic state.
True
True/False
Chronic hyperglycemia can result in a decrease in the polyol pathway, which can lead to a decrease in protein kinase C levels.
False. increase... increase
Normal plasma glucose concentration is about ____________.
75-100 mg%
True/False
Muscle, liver and kidney are three organs that are capable of storing glucose as glycogen and undergoing glycogenolysis during periods when glucose levels fall in order to maintain glucose homeostasis.
False. Liver and kidney only
True/False
GLP-1 enhances insulin secretion and inhibits glucagon secretion.
True
True/False
Insulin release is needed for the uptake of glucose into the exercising muscle.
False. is not needed
True/False
As part of therapy for a Type 1 diabetic patient, the administration of somatostatin could be beneficial.
True
True/False
There is a strong correlation with certain HLA halotypes in diabetes. Approximately 95% of the Type 2 diabetic patients have these associated halotypes whereas these halotypes are only seen in 20 % of the general population.
False. Type 1
True/False
A woman with gestational diabetes gives birth to a son. At birth this offspring is at risk for the development of hyopoglycemia.
True
True/False
Name a pancreatic hormone that causes an increase in hepatic cAMP levels and results in an increase in plasma glucose by the liver? ____________
glucagon
True/False
Measurement of ___________ in the blood is the best indicator of the function of the beta cells of the pancreas.
c-peptide
Your neighbor has gained 80 lbs in the last year. Although asymptomatic, her fasting blood glucose is in excess of 200 mg%. The most probable diagnosis for this patient is __________________.
Type 2 Diabetes
Every 1 % of glycated HbA1c is equal to about ___________ mg/dl of plasma glucose.
29
TNF-alpha is elevated in obesity and has been shown to reduce the levels of _________________ .
Glut 4 transporters
True/False
Hypothermia, confusion, seizures and coma are neurogenic symptoms associated with diabetic ketoacidosis.
False. Hyperthermia... hypoglycemia.
True/False
Diabetic women who are pregnant should be aware that in the early stages of pregnancy there may be an elevated risk for hypoglycemia.
True
True/False
Macroangiopathy complications mainly present as neuropathies, retinopathies, or nephropathies.
False. Microangiopathy
True/False
One of the drawbacks or negatives of the DCCT was the increase incidence of hypoglycemia in the “tight” treatment group.
True
During decompensatory or irreversible shock, which of the following is INCORRECT?
a. The continued SNS stimulation can become detrimental.
b. Patients can become acidotic and develop ATN and ARDS.
c. Affected tissues shift to anaerobic metabolism and, as a result, membrane function is eventually compromised.
d. The increase in oncotic pressure at the capillary level can help restore cardiac output.
d. The increase in oncotic pressure at the capillary level can help restore cardiac output.
Homer, a healthy 30 year old man, wakes at 7 am. He has not eaten for 12 hours. Which of the following plasma glucose levels would be considered normal at this time?
a. 36 mg/dl
b. 76 mg%
c. 136 mg/dl
d. 200 mg%
b. 76 mg%
__________________ can stimulate the enzyme, aldose reductase.
high levels of glucose (hyperglycemia)
In a diabetic patient what is the target level one would like to achieve for LDL’s? ______________________
< 100 mg/dl