Diabetic Patient Blood Pressure Management Quiz
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Questions and Answers

What is the emphasis on lifestyle modifications in managing type two diabetes?

  • It is recommended to focus on lifestyle modifications only during the initial visit.
  • Lifestyle modifications should be mentioned at every visit to the patient. (correct)
  • Lifestyle modifications are not crucial for optimal weight management in diabetic patients.
  • Lifestyle modifications are only important if the patient is unable to achieve optimal weight.

    • Why does the text suggest setting short and simple weight loss goals for diabetic patients?

  • To delay the achievement of weight loss goals to avoid hypoglycemia.
  • To ensure the patient achieves an optimal weight within a short timeframe.
  • To overwhelm the patient with the goal of losing a large amount of weight quickly.
  • Because small increments in weight loss have been shown to make a significant difference in A1C levels. (correct)

    • How often should glycemic targets be adjusted for diabetic patients?

  • Once a year
  • Every month
  • Every 6 months
  • About every 3 months (correct)

    • What is the recommended A1C level for optimal management in diabetic patients?

    <p>Less than or equal to 6.5%</p> Signup and view all the answers

    Why is it essential to individualize glycemic targets for diabetic patients?

    <p>To tailor treatment based on each patient's GMAR, T, fasting blood glucose, and postprandial glucose levels</p> Signup and view all the answers

    What is the suggested frequency for checking hemoglobin A1C in diabetic patients?

    <p>Every 3 months</p> Signup and view all the answers

    What is the recommended LDL target for individuals at high risk with type two diabetes?

    <p>Less than 70</p> Signup and view all the answers

    Which of the following is NOT considered a major risk factor according to the ICE SCV risk reduction algorithm for dyslipidemia?

    <p>Obesity</p> Signup and view all the answers

    What is the recommended triglycerides level for individuals at very high risk?

    <p>Less than 150</p> Signup and view all the answers

    When should individuals be monitored to achieve their lipid goal according to the text?

    <p>Every three to six months</p> Signup and view all the answers

    What additional therapy should be considered if an individual has not reached their target LDL?

    <p>Niacin</p> Signup and view all the answers

    What is the recommended initial blood pressure for starting therapy in diabetic patients?

    <p>150 over 100</p> Signup and view all the answers

    What is the first-line medication recommendation for elderly patients with diabetes?

    <p>Metformin</p> Signup and view all the answers

    In diabetic patients with high risk for heart failure, which medication class is recommended?

    <p>GLP-1 receptor antagonist</p> Signup and view all the answers

    What is the recommended minimum duration for aerobics activity per week for individuals with a BMI less than or equal to 25?

    <p>150 minutes</p> Signup and view all the answers

    What is the glycaemic target advised for most patients according to the text?

    <p>6.5% or less</p> Signup and view all the answers

    At what BMI range is structured exercise with oversight and accountability advised, along with consideration of weight loss medications and screening for sleep disturbances?

    <p>Greater than 25 to 27</p> Signup and view all the answers

    Which medication class should be avoided in diabetic patients at risk of hypoglycemia?

    <p>Sulfonylureas</p> Signup and view all the answers

    What is the primary goal of lifestyle interventions in the prediabetes algorithm?

    <p>Prevent progression to diabetes</p> Signup and view all the answers

    What medication is recommended as an alternative for diabetic patients who cannot afford GLP-1 receptor antagonists or SGLT-2 inhibitors due to cost?

    <p>Insulin</p> Signup and view all the answers

    Which medication is NOT specifically mentioned as an option for individuals with persistent hypoglycemia in the context provided?

    <p>GLP-1 receptor antagonist</p> Signup and view all the answers

    At what BMI stage is the consideration of bariatric surgical options mentioned in the text?

    <p>&gt; 35</p> Signup and view all the answers

    What should individuals with a BMI greater than 27 to 30 be referred for as part of their care?

    <p>Sleep study</p> Signup and view all the answers

    How often should insulin be titrated to reach glycaemic goals with a fixed regimen?

    <p>Every 2-5 days</p> Signup and view all the answers

    When should prandial insulin be considered in the treatment regimen?

    <p>With severe hypoglycemia</p> Signup and view all the answers

    Which type of insulin is preferred over regular insulin when adding prandial insulin?

    <p>Rapid-acting analogs</p> Signup and view all the answers

    What is the total daily dose range of basal insulin recommended for patients with a HbA1c less than 8%?

    <p>0.1 to 0.2 units per kilogram</p> Signup and view all the answers

    What percentage of the total daily dose should be added if fasting blood glucose is between 140 to 180 mg/dL?

    <p>10% of total daily dose</p> Signup and view all the answers

    In what scenario should prandial insulin be initiated before the largest meal?

    <p>10 percent of basal or 5 units</p> Signup and view all the answers

    What is the purpose of vaccine recommendations for persons with Type two diabetes?

    <p>To make sure individuals with compromised immune systems are up to date on necessary vaccines</p> Signup and view all the answers

    What change was highlighted regarding Prevnar vaccines?

    <p>The dosage has been increased from Prevnar 15 to Prevnar 20</p> Signup and view all the answers

    Why is it important to assess the immunization status of individuals with Type two diabetes at every encounter?

    <p>To keep track of their vaccine history and ensure they are protected</p> Signup and view all the answers

    What is the significance of staying up to date on the latest CDC recommendations for vaccines?

    <p>To ensure individuals receive the most effective vaccines available</p> Signup and view all the answers

    Why is it important to strongly recommend vaccines based on age or risk factors?

    <p>To ensure individuals receive necessary protection against diseases.</p> Signup and view all the answers

    Which statement is true about administering vaccines to individuals with Type two diabetes?

    <p>Administering vaccines should be done regularly based on CDC recommendations.</p> Signup and view all the answers

    What should be done if an individual has started on a specific vaccine but the recommendation changes?

    <p>Refer to an algorithm based on the new recommendation.</p> Signup and view all the answers

    How often should one check for changes in vaccine recommendations according to the text?

    <p>Frequently but not specified</p> Signup and view all the answers

    What is meant by 'highlight positive experiences and benefits of vaccines' mentioned in the text?

    <p>Encouraging patients by focusing on positive aspects of vaccination.</p> Signup and view all the answers

    How can one document receipt of a vaccine according to the text?

    <p>By entering it into an immunization registry or electronic health record.</p> Signup and view all the answers

    Which hormone stimulates the production and release of TSH from the pituitary gland?

    <p>TRH</p> Signup and view all the answers

    Which thyroid hormone is four times more potent than T4?

    <p>T3</p> Signup and view all the answers

    Which protein serves as the major carrier for thyroid hormones in the blood?

    <p>TBG</p> Signup and view all the answers

    Which hormone controls thyroid function through a pulsatile circadian secretion pattern?

    <p>TSH</p> Signup and view all the answers

    Which gland synthesizes a glycoprotein hormone that controls thyroid function?

    <p>Pituitary gland</p> Signup and view all the answers

    In what form are thyroid hormones stored within the thyroid gland?

    <p>Thyroglobulin</p> Signup and view all the answers

    Which hormone stimulates the production and release of T4 from the thyroid gland?

    <p>TSH</p> Signup and view all the answers

    What is the primary function of thyroglobulin in the thyroid gland?

    <p>Hormone storage</p> Signup and view all the answers

    Which hormone is synthesized in the hypothalamus and controls TSH production?

    <p>TRH</p> Signup and view all the answers

    What are the primary functions regulated by thyroid hormones?

    <p>Energy and heat production</p> Signup and view all the answers

    Which aspect of cellular activity is NOT influenced by thyroid hormones?

    <p>Insulin secretion</p> Signup and view all the answers

    What is the classification of thyroid dysfunction based on the portion of the HPT axis that is dysfunctional?

    <p>Primary, secondary, and tertiary</p> Signup and view all the answers

    Which autoimmune disease causes hyperthyroidism?

    <p>Graves' disease</p> Signup and view all the answers

    What is the primary location of dysfunction in secondary thyroid dysfunction?

    <p>Pituitary gland</p> Signup and view all the answers

    Which gland is primarily impacted by tertiary thyroid dysfunction?

    <p>Hypothalamus</p> Signup and view all the answers

    What are the two most common autoimmune problems affecting the thyroid gland?

    <p>Graves' disease and Hashimoto's thyroiditis</p> Signup and view all the answers

    Which aspect of cellular activity is affected by an increase in the number and size of mitochondria due to thyroid hormones?

    <p>$\text{ATP production}$</p> Signup and view all the answers

    What is the most common cause of thyroid disease?

    <p>Autoimmune disease</p> Signup and view all the answers

    When should TSH be re-evaluated after changing the dose of levothyroxine?

    <p>6-8 weeks</p> Signup and view all the answers

    What is the recommended timing for giving drugs that interfere with the absorption of levothyroxine?

    <p>3-4 hours after taking levothyroxine</p> Signup and view all the answers

    How often should measurement of TSH be done until a patient is euthyroid?

    <p>Every 6 weeks</p> Signup and view all the answers

    For which condition is referral to an endocrinologist indicated according to the text?

    <p>Congenital hypothyroidism</p> Signup and view all the answers

    What is the recommended administration instruction for levothyroxine in terms of the stomach condition?

    <p>Take on an empty stomach</p> Signup and view all the answers

    At what age should TSH be monitored annually according to the text?

    <p>&lt; 12 years old</p> Signup and view all the answers

    How long does it take to achieve a steady state after changing the dose of levothyroxine?

    <p>6-8 weeks</p> Signup and view all the answers

    What is the time frame for referral to an endocrinologist for congenital hypothyroidism?

    <p>&lt; 6 months old</p> Signup and view all the answers

    When should individuals be examined periodically for signs of thyrotoxicity?

    <p>&gt; 6 months after starting medication</p> Signup and view all the answers

    Which clinical state is a result of resistance to the action of the thyroid hormone?

    <p>Hypothyroidism</p> Signup and view all the answers

    What symptom is NOT typically associated with hypothyroidism?

    <p>Increased sweating</p> Signup and view all the answers

    What is the initial test recommended for assessing thyroid function?

    <p>TSH</p> Signup and view all the answers

    What is a common risk factor for hypothyroidism?

    <p>Autoimmune diseases</p> Signup and view all the answers

    What is the typical presentation of hypothyroidism?

    <p>Periorbital edema</p> Signup and view all the answers

    Which medication may interfere with thyroid metabolism?

    <p>Amiodarone</p> Signup and view all the answers

    What symptom is NOT a common symptom of hypothyroidism?

    <p>High blood pressure</p> Signup and view all the answers

    What is the next step if TSH is abnormal during thyroid function testing?

    <p>Check Free T4</p> Signup and view all the answers

    What is the significance of maternal hypothyroidism largely being limited to the first trimester?

    <p>The fetus cannot produce its own thyroid hormones in the first trimester.</p> Signup and view all the answers

    Why is it recommended to monitor TSH levels every 6-8 weeks when adjusting levothyroxine dosage?

    <p>To know whether the deficiency is permanent or transient.</p> Signup and view all the answers

    What can congenital hypothyroidism in newborns lead to?

    <p>All of the above.</p> Signup and view all the answers

    Why is levothyroxine dosage adjustment necessary during pregnancy?

    <p>To ensure adequate supply of thyroid hormones to the fetus.</p> Signup and view all the answers

    What is the concern regarding treatment of subclinical hypothyroidism with levothyroxine?

    <p>Potential development of osteoporosis.</p> Signup and view all the answers

    Why is dosing adjusted based on ideal weight in obese patients receiving levothyroxine?

    <p>To maintain proper thyroid hormone levels.</p> Signup and view all the answers

    What distinguishes Armour Thyroid from Levothyroxine?

    <p>Armour Thyroid contains both T3 and T4.</p> Signup and view all the answers

    What is an implication of congenital hypothyroidism if left untreated?

    <p>'Dwarfish' stature and mental development delay.</p> Signup and view all the answers

    'Start low and go slow' refers to what approach in treating elderly patients with levothyroxine?

    <p>Initiating therapy at a low dose and gradually increasing as needed.</p> Signup and view all the answers

    What distinguishes Liothyronine sodium [Cytomel] from Levothyroxine?

    <p>Liothyronine sodium [Cytomel] replaces T3 only while Levothyroxine replaces T4 only.</p> Signup and view all the answers

    What is a notable disadvantage of I-131 treatment according to the text?

    <p>Delayed treatment response</p> Signup and view all the answers

    In which situation is I-131 treatment contraindicated?

    <p>Pregnancy</p> Signup and view all the answers

    What adverse effects are associated with the Lugol solution?

    <p>Brassy taste, burning sensation, headache</p> Signup and view all the answers

    Which thyroid disorder is I-131 used for diagnosing according to the text?

    <p>Goiter</p> Signup and view all the answers

    What is indicated by a fixed, firm, non-tender nodule found in the thyroid gland?

    <p>Malignancy</p> Signup and view all the answers

    Which thyroid function tests are used for diagnostics according to the text?

    <p>Thyroid scintigraphy and needle aspiration biopsy</p> Signup and view all the answers

    What symptoms may be present in patients with a thyroid nodule?

    <p>Hoarseness and cough</p> Signup and view all the answers

    What is a significant risk factor for developing a thyroid nodule according to the text?

    <p>Iodine deficiency</p> Signup and view all the answers

    What is the primary management recommendation for patients with multiple nodules in their thyroid?

    <p>Observation and follow-up</p> Signup and view all the answers

    When should individuals with a suspicious thyroid nodule be referred to an endocrinologist?

    <p>Upon detection of a fixed, firm nodule</p> Signup and view all the answers

    What is the most dangerous toxicity associated with methimazole?

    <p>Agranulocytosis</p> Signup and view all the answers

    Which drug is preferred during the first trimester of pregnancy due to its lower risk of crossing the placenta?

    <p>Propylthiouracil (PTU)</p> Signup and view all the answers

    What is the potential consequence of using high doses of methimazole?

    <p>Hypothyroidism</p> Signup and view all the answers

    Which thyroid medication has the property of blocking the conversion of T4 to T3 in the periphery?

    <p>Propylthiouracil (PTU)</p> Signup and view all the answers

    What is the half-life of radioactive iodine 131?

    <p>8 days</p> Signup and view all the answers

    Why is methimazole considered the first-line drug for hyperthyroidism?

    <p>It does not cause liver damage associated with PTU</p> Signup and view all the answers

    What effect can radioactive iodine have on thyroid tissue?

    <p>Destruction</p> Signup and view all the answers

    What is the main difference between the properties of PTU and methimazole?

    <p>Placental crossing ability</p> Signup and view all the answers

    What is the primary mechanism by which Grave's disease causes hyperthyroidism?

    <p>Autoimmune stimulation of TSH receptors</p> Signup and view all the answers

    Which condition results from an expansion of clonogenic cells with an activating TSH receptor mutation?

    <p>Toxic adenoma</p> Signup and view all the answers

    What is the characteristic feature of transient thyroiditis?

    <p>Autoimmune destruction of thyroid tissue</p> Signup and view all the answers

    Which of the following is NOT a common cause of hyperthyroidism?

    <p>Drug-induced hypothyroidism</p> Signup and view all the answers

    What autoimmune process stimulates the TSH receptor in Grave's disease?

    <p>Antibodies acting on the TSH receptor</p> Signup and view all the answers

    Which medication is commonly associated with drug-induced thyroiditis?

    <p>Amiodarone</p> Signup and view all the answers

    What distinguishes toxic multinodular goiter from transient thyroiditis?

    <p>Clonogenic cells expansion</p> Signup and view all the answers

    What is the primary cause of painless or transient thyroiditis?

    <p>Viral infection triggering hormone release</p> Signup and view all the answers

    What is the characteristic feature of a toxic adenoma (Plummer disease)?

    <p>Somatic mutation in GS alpha gene</p> Signup and view all the answers

    Which condition is characterized by an activating TSH receptor mutation and expansion of clonogenic cells?

    <p>Toxic multinodular goiter</p> Signup and view all the answers

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