Wk 2-July 11 Endocrine

Which one of the following is most likely to cause hypoglycemia in elderly patients?

An 86-year-old female nursing-home resident has type 2 diabetes mellitus, chronic diastolic heart failure, chronic kidney disease, advanced osteoarthritis, hypertension, Alzheimer's disease, and other comorbidities. She requires assistance with dressing, bathing, and feeding. For this patient, the American Geriatrics Society recommends a hemoglobin A1c goal of

Which one of the following hypoglycemic medications is proven to reduce mortality rates in patients with type 2 diabetes mellitus?

You recently diagnosed diabetes mellitus in a 49-year-old male who also has chronic kidney disease and New York Heart Association class III heart failure. Laboratory studies are remarkable for a serum creatinine level of 2.0 mg/dL (N 0.6–1.2) and an estimated glomerular filtration rate of 40 mL/min/1.73 m2. Which one of the following classes of agents would be most appropriate for this patient?

A 75-year-old male is admitted to the intensive-care unit with sepsis. His past medical history is significant for diabetes mellitus and coronary artery disease. Which one of the following would be the most appropriate maximum blood glucose goal?

A 19-year-old man with a BMI of 35, comes to your office with polyuria, polydipsia and polyphagia. In the process of working him up you determine that he may have diabetes. Which of the following tests can you use to diagnose him with diabetes?

A 48-year-old female sees you for routine follow-up. She was diagnosed with type 2 diabetes mellitus 2 years ago and has been treated with metformin (Glucophage), 850 mg orally 3 times daily, and glipizide (Glucotrol XL), 20 mg orally daily, along with diet and exercise. Her other medical problems include hypertension and obesity. She has no known cardiovascular disease or microvascular complications. She came in for laboratory testing yesterday, and her hemoglobin A1c is 8.0% (N <5.7%). Which one of the following medications would help with both glycemic control and weight loss for this patient?

A 34-year-old white female presents with complaints of polydipsia, polyuria, and fatigue. Her family history is positive for diabetes mellitus. On examination she has a BMI of 38 kg/m2. Her fasting blood glucose level is 152 mg/dL and her hemoglobin A1c is 8.5%. Her fasting blood glucose level was 89 mg/dL 6 months ago. She says her vision has been somewhat blurry lately, but she has not noticed any tingling in her feet. Which one of the following initial management options would be most appropriate?

A 45-year-old female with a BMI of 50.0 kg/m2 comes to your office to discuss treatment of her chronically elevated fasting glucose levels. Recent test results include a hemoglobin A1c of 6.0%. In the past she was not able to tolerate metformin (Glucophage) and would like to try another medication to reduce her risk of developing diabetes mellitus. Which one of the following medications would be most appropriate for this patient?

A 25-year-old gravida 1 para 0 presents for follow-up of gestational diabetes mellitus. She had a positive screening test at her 24-week visit last week and has been checking her blood glucose at home twice daily since that time. She is not currently on any diabetes medications and has a nutrition visit scheduled for later today. She is currently unclear on what her glucose level should be at various times throughout the day. Which one of the following is the goal fasting blood glucose in this patient?