Anesthesia Pharmacology Chapter 
23:  Co-Existing Disease:  Diabetes Practice Questions
 
 
- Second generation sulfonylurea antidiabetic drug: -   chlorpropamide (Diabinese)
-   Tolbutamide (Orinase)
-   glipizide (Glucotrol)
-   A & C
-   A, B & C
 
- Clinically use(s) for glucagon: -   management of severe hyperglycemia
-   beta adrenergic receptor poisoning
-   diagnostic uses
-   B & C
-   A & C
 
-  Major manifestations of diabetes: -   metabolic disorders
-   inappropriate hyperglycemia
-   both
-   neither
 
- Insulin-dependent diabetes mellitus: -   Type I
-   Type II
 
- Characteristics of Type I diabetes: -   typically adult onset
-   low plasma glucagon
-   insulin nearly absent
-   pancreatic B cell is responsive to insulinogenic stimuli
 
- In a patient with Type I diabetes, exogenous insulin is required to: -   prevent ketosis
-   reverse hypoglucagonemia
-   reverses catabolic state
-   A & C
-   A, B & C
 
- Symptoms Secondary to Hyperglycemia in a Type I Diabetic Patient -   polyuria
-   polydipsia
-   polyphagia
-   A, B & C
-   none of the above
 
- Cause(s) of metabolic effecct(s) associated with Type I diabetes: -   relative or significant glucagon excess
-   an increase in glucagon/insulin ratio
-   excessive insulin concentration
-   A & B
-    A, B & C
 
- IDDM: typical age of onset -   less than 40 years of age
-   greater than 40 years of age
 
- Acute complication: NIDDM -   ketoacidosis
-   hyperosmolar coma
 
- Plasma insulin concentration: NIDDM -   low to absent
-   normal to high
 
- IDDM: response to sulfonylurea drugs: -   unresponsive
-   responsive
 
- Characteristic(s)of Type II diabetes: -   Group of milder forms of diabetes
-   Occurs mainly in children
-   Obesity: common risk factor
-   A & C
-   A, B & C
 
- Clinical presentation: NIDDM -   usually developed ketoacidosis
-   exhibits volume excess
-   CNS symptoms
-   exhibits hypo-osmolality
 
- Hyperosmolar, nonketotic coma: -   caused by sustained hyperglycemia diuresis when patients cannot drink enough water to keep up with urinary fluid loss
-   complete manifestation occurs when volume depletion decreases urine output
-   both
-   neither
 
- Treatment of hyperosmolar coma states -   large amounts of IV fluids
-   insulin
-   potassium salts
-   sodium bicarbonate
-   all the above
 
- Type II diabetes treatment -- -   weight reduction
-   diet
-   insulin
-   sulfonylurea drugs
-   all the both
 
- Clinical use for short-acting insulin -   IV treatment for diabetic ketoacidosis
-   management of rapidly changing insulin requirements
-   both
-   neither
 
- Tight glycemic control recommended: -   for patients with advance renal disease
-   elderly
-   children under the age of seven years
-   none of the above
 
- Most common complication of insulin treatment -   excessive appetite
-   tachycardia, palpitations -- sympathetic overactivity
-   hypoglycemia