Complications Management Flashcards
7 cards from real BC ADM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Complications Management flashcards as text
A diabetic patient with gastroparesis has erratic postprandial glucose levels. Which insulin timing strategy is most appropriate?
Answer: Administer rapid-acting insulin after meals once food intake is confirmed
Post-meal rapid-acting insulin administration avoids hypoglycemia from unpredictable gastric emptying causing delayed glucose absorption.
Which test is considered the gold standard for diagnosing diabetic gastroparesis?
Answer: Gastric emptying scintigraphy at 4 hours
4-hour solid-phase gastric emptying scintigraphy is the gold standard, with retention >10% at 4 hours confirming gastroparesis.
A patient with long-standing T1DM reports orthostatic dizziness. Blood pressure drops 28 mmHg systolic upon standing. What is the recommended initial management?
Answer: Increase fluid and salt intake, compression stockings, and head-of-bed elevation
Non-pharmacological measures (fluid/salt loading, compression, head-of-bed elevation) are first-line for diabetic autonomic orthostatic hypotension.
Which finding on nerve conduction study confirms diabetic peripheral neuropathy?
Answer: Reduced sural nerve sensory conduction velocity and amplitude
Reduced sural nerve sensory conduction velocity and amplitude are the earliest and most sensitive NCS findings in diabetic neuropathy.
A patient with diabetic nephropathy is on an ACE inhibitor but still has urine ACR of 380 mg/g. Adding which drug class provides additional renoprotection per 2024 ADA guidelines?
Answer: Finerenone (non-steroidal MRA)
Finerenone, a non-steroidal mineralocorticoid receptor antagonist, provides additional kidney and cardiovascular protection in CKD with T2DM on top of RAS blockade.
Severe non-proliferative diabetic retinopathy follows the '4-2-1 rule.' Which finding triggers the 4-2-1 classification?
Answer: Hemorrhages in 4 quadrants, venous beading in 2 quadrants, or IRMA in 1 quadrant
The 4-2-1 rule defines severe NPDR: dot/blot hemorrhages in all 4 quadrants, venous beading in ≥2 quadrants, or IRMA in ≥1 quadrant.
A diabetic patient with CKD and heart failure is started on dapagliflozin. Which mechanism accounts for its heart failure benefit?
Answer: Osmotic diuresis reducing preload and afterload with direct myocardial effects
SGLT2 inhibitors reduce plasma volume via osmotic diuresis and natriuresis, decrease afterload, and have direct cardioprotective metabolic effects on myocytes.