Question 1

Which of the following is true of retinopathy as a consequence of diabetes?&#10;A) It is the leading cause of blindness in the United States.&#10;B) Proliferative retinopathy is most common among patients with type 2 diabetes.&#10;C) Cataracts occur at an earlier age and with greater frequency in those with type 1 diabetes.&#10;D) a, b, and c&#10;E) a and c

Accepted Answer

Retinopathy occurs in all forms of diabetes.It is the leading cause of blindness in the United States.Proliferative retinopathy is most common among patients with type 1 diabetes; a much lower incidence is seen among those with type 2 diabetes.Cataracts occur at an earlier age and with greater frequency in those with type 1 diabetes.The typical cataract,senile cataract,is identified in 59% of persons with diabetes aged 35 to 55 years but in only 12% of those without the disease.The risk that a person with diabetes will become blind is 20 times greater than that for the general population.

Question 2

The relative risk that patients with diabetes will require amputation of an extremity because of diabetic complications is more than ___ times that of normal persons.&#10;A) 10&#10;B) 20&#10;C) 30&#10;D) 40

Accepted Answer

It is more than 40 times that of normal persons.Diabetes is associated with gangrenous extremities.Recent data show that more than 65,000 amputations are performed annually in patients with diabetes mellitus.This number represents more than 60% of all nontraumatic amputations.

Question 3

Which of the following symptoms is commonly associated with the clinical presentation of type 2 diabetes,in contrast to type 1 diabetes?&#10;A) acute onset&#10;B) polydipsia, polyuria, polyphagia&#10;C) insulin receptor defects&#10;D) ketoacidosis

Accepted Answer

Insulin receptor defects are often found in patients with type 2 diabetes,and are usually not found in patients with type 1 diabetes.The onset of symptoms in patients with type 1 diabetes is sudden and acute,often developing over days or weeks.Symptoms and signs of type 1 diabetes include polydipsia,polyuria,polyphagia,weight loss,loss of strength,marked irritability,recurrence of bed wetting,drowsiness,malaise,and blurred vision.Patients with type 1 diabetes may also present with ketoacidosis,which,if severe,is accompanied by vomiting,abdominal pain,nausea,tachypnea,paralysis,and loss of consciousness.

Question 4

Adults with uncontrolled diabetes have more severe manifestations of periodontal disease than do adults without diabetes.As a group,patients with controlled diabetes appear to have more severe periodontal disease than do those without it,but the differences are not great.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true, the second statement is false.
D) The first statement is false, the second statement is true.

Accepted Answer

The time relationship between the occurrence of the diabetic state and the onset of periodontal disease has yet to be established.However,periodontal disease is clearly a complication of type 1 and type 2 diabetes,and the association cannot be explained solely by increased supragingival plaque accumulations.

Question 5

Sulfonylurea drugs are members of which of the following classes of drugs used to treat type 2 diabetes?&#10;A) insulin sensitizer&#10;B) insulin secretagogue&#10;C) drugs that slow the absorption of carbohydrates in the gut&#10;D) incretins

Accepted Answer

Sulfonylurea drugs are the largest class of drugs used to treat type 2 diabetes.They are secretagogues.Insulin secretagogues are agents that bind to the sulfonylurea receptor on the plasma membrane of pancreatic beta cells,causing insulin secretion from the pancreas.

Question 6

Which of the following is true regarding the dental use of local anesthetic and epinephrine for the patient with diabetes?&#10;A) For most patients with diabetes, routine use of local anesthetic with 1:100,000 epinephrine is contraindicated.&#10;B) Epinephrine has a pharmacologic effect that is opposite of insulin.&#10;C) In diabetic patients with hypertension, caution may be indicated with use of epinephrine.&#10;D) a and b&#10;E) b and c

Accepted Answer

For most patients with diabetes,routine use of local anesthetic with 1:100,000 epinephrine should be well tolerated.Epinephrine has a pharmacologic effect that is opposite of insulin,so blood glucose could rise with the use of epinephrine.In diabetic patients with hypertension,history of recent myocardial infarction,or cardiac arrhythmia,caution may be indicated with use of epinephrine.

Question 7

(A/An)__% increased risk of infection postoperatively following surgical procedures has been reported if fasting blood glucose level rises to above 230 mg/100 mL.&#10;A) 20&#10;B) 40&#10;C) 60&#10;D) 80

Accepted Answer

If fasting blood glucose level rises to above 230 mg/100 mL,an 80% increased risk of infection has been reported.If the fasting blood glucose level is between 207 and 229 mg/100 mL,the risk for infection is predicted to be increased by 20% if surgical procedures are being performed.

Question 8

Which of the following is the most common cause of death in patients with type 2 diabetes?&#10;A) heart attack&#10;B) gangrene&#10;C) stroke&#10;D) renal failure

Accepted Answer

The most common cause of death in patients with type 2 diabetes is myocardial infarction.By age 60,a third of all persons with diabetes die of complications from coronary heart disease (CHD).Women with diabetes treated with insulin are at higher risk for CHD than non-insulin-treated women.This is not true for insulin-treated men.Also,diabetics are at a two- to four-fold greater risk for myocardial infarction and stroke than persons without the disease.

Question 9

Which of the following is the leading cause of death in patients with type 1 diabetes?&#10;A) stroke&#10;B) renal failure&#10;C) heart attack&#10;D) hypertension

Accepted Answer

Renal failure is the leading cause of death in patients with type 1 diabetes.Diabetics are 25 times more likely to acquire end-stage renal disease than persons without diabetes.Diabetic nephropathy leads to end-stage renal disease in 30% to 40% of patients with type 1 diabetes and in 5% of patients with type 2 diabetes.Of all patients who undergo dialysis,37% have diabetes.

Question 10

What are recommendations for preventing insulin shock for the dental patient who is going to have intravenous sedation for a dental procedure?&#10;A) Maintain their usual insulin dose prior to the appointment.&#10;B) Supplement with intravenous glucose during the procedure.&#10;C) Skip their normal meal (fast) prior to the appointment.&#10;D) a and b&#10;E) b and c

Accepted Answer

A protocol for intravenous sedation in the dental management of a patient with diabetes often involves fasting before the appointment (i.e.,nothing by mouth after midnight)and using only half the usual insulin dose,and then supplementing with intravenous glucose during the procedure.

Question 11

The American Diabetes Association recommends screening tests for diabetes mellitus for all persons who are __ years of age and older.&#10;A) 35&#10;B) 45&#10;C) 55&#10;D) 65

Accepted Answer

The answer of The American Diabetes Association recommends screening tests...

Question 12

What are recommendations to prevent insulin shock during a routine dental appointment in a patient with diabetes?&#10;A) Skip their usual insulin dose prior to the appointment.&#10;B) Schedule a morning appointment.&#10;C) Skip their normal meal (fast) prior to the appointment.&#10;D) a and b&#10;E) b and c

Accepted Answer

The answer of What are recommendations to prevent insulin shock...

Question 13

Which of the following types of human insulin are used at meals for type 1 diabetes?&#10;A) lispro and aspart&#10;B) lente&#10;C) ultralente&#10;D) a and b

Accepted Answer

The answer of Which of the following types of human...

Question 14

Which of the following medications is an incretin?&#10;A) nateglinide (Starlix)&#10;B) exenatide (Byetta)&#10;C) metformin (Glucophage)&#10;D) acarbose (Precose)

Accepted Answer

The answer of Which of the following medications is an...

Question 15

Which of the following is the major reason why the prevalence of diabetes mellitus has increased more than six-fold in the United States over the past 40 years?&#10;A) increasing population&#10;B) increasing life expectancy&#10;C) increasing epidemic of obesity&#10;D) increasing number of affected persons who are having children who will pass on the disease

Accepted Answer

The answer of Which of the following is the major...

Deck 14: Diabetes Mellitus