Mixed Deck — All BC ADM Topics Flashcards

A patient with type 2 diabetes has poorly controlled A1C despite reporting adherence. During the visit, you learn they work night shifts. Which psychosocial and practical factor should be addressed first?

Answer: Explore how shift work affects sleep, meals, and medication timing

Shift work disrupts circadian rhythms, eating patterns, and medication schedules, all of which can significantly impair glycemic control.

When educating a patient about carbohydrate foods, which of the following contains the HIGHEST amount of digestible (net) carbohydrate per serving?

Answer: 1 medium banana

A medium banana contains approximately 27 g of carbohydrate, significantly more than lentils (~20 g with higher fiber offset), broccoli (~6 g), or almonds (~6 g).

Which social determinants of health (SDOH) most significantly impact a patient's ability to manage type 2 diabetes effectively?

Answer: Food insecurity, housing instability, and lack of reliable transportation

Food insecurity, housing instability, and transportation barriers are well-documented social determinants that directly impair diabetes self-management — they affect medication adherence, diet quality, and the ability to attend appointments. While distance to specialists matters, the triad of food, housing, and transportation insecurity represents the most modifiable and clinically impactful SDOH cluster for diabetes management.

How does the BC ADM body of knowledge relate to daily professional practice?

Answer: It provides the foundational framework that guides decision-making and standard practices

The body of knowledge provides the foundational framework of principles, standards, and best practices that professionals use to guide their daily decision-making, ensure consistent quality, and maintain alignment with industry standards.

Which mechanism best explains the progressive beta-cell decline seen in type 2 diabetes over time?

Answer: Glucotoxicity and lipotoxicity causing oxidative stress and apoptosis

Chronic hyperglycemia (glucotoxicity) and elevated free fatty acids (lipotoxicity) generate reactive oxygen species that drive beta-cell apoptosis and functional decline.

During underwater diving, a person with type 1 diabetes should ensure pre-dive blood glucose is at least what level to reduce hypoglycemia risk?

Answer: 150 mg/dL

Expert recommendations suggest a pre-dive glucose of at least 150 mg/dL to provide a safety margin against hypoglycemia, which is extremely dangerous underwater.

What laboratory test is commonly used to diagnose diabetes?

Answer: HbA1c test

The HbA1c test measures a person's average blood glucose levels over the past 2-3 months by assessing the percentage of hemoglobin in red blood cells that is glycated. It is a widely accepted and convenient diagnostic tool for diabetes because it provides a long-term picture of blood sugar control, unlike a single glucose reading which can fluctuate daily. A result of 6.5% or higher is typically diagnostic of diabetes.

A 16-year-old with type 1 diabetes has an A1C of 7.2% but reports frequent hypoglycemia. The BEST next step is to:

Answer: Evaluate timing and causes of hypoglycemic episodes

Evaluating the pattern and causes of hypoglycemia allows targeted adjustments rather than broad insulin reductions that may worsen overall control.

Acanthosis nigricans in a patient with diabetes is a clinical marker of:

Answer: Severe insulin resistance with hyperinsulinemia

Acanthosis nigricans (velvety hyperpigmentation in skin folds) is a cutaneous sign of significant insulin resistance and chronic hyperinsulinemia.

In Advanced Diabetes Management Certification, what is the PRIMARY purpose of conducting regular safety drills and exercises?

Answer: To ensure personnel can respond effectively in emergencies

Regular safety drills ensure that all personnel are prepared to respond effectively during actual emergencies. Practice builds muscle memory, identifies gaps in emergency procedures, and improves overall response times.

A patient with peripheral neuropathy wants to begin a resistance training program. Which precaution is MOST important?

Answer: Inspect feet carefully before and after each session and wear proper footwear

Peripheral neuropathy impairs protective sensation, so meticulous foot inspection and appropriate footwear are essential to prevent undetected injury during exercise.

What role does islet amyloid polypeptide (IAPP/amylin) play in the pathophysiology of type 2 diabetes?

Answer: Aggregated IAPP fibrils are cytotoxic to beta cells and contribute to islet destruction

IAPP co-secreted with insulin forms toxic oligomeric and fibrillar aggregates within islets that impair beta-cell function and promote apoptosis in type 2 diabetes.

Diabetic ketoacidosis (DKA) in pregnancy is most dangerous because it can occur at a blood glucose level as low as:

Answer: 180 mg/dL

Pregnancy lowers the threshold for DKA; euglycemic DKA can occur at glucose levels as low as 180 mg/dL due to altered metabolism and increased ketogenesis.

What is the first priority in insulin therapy for BC ADM practitioners?

Answer: Ensuring patient safety and well-being

Patient safety and well-being must always be the first priority in clinical practice, taking precedence over administrative concerns.

A registered dietitian is counseling a patient with T1DM who wants to follow a plant-based diet. The primary nutritional concern unique to this eating pattern in insulin-requiring patients is:

Answer: Difficulty accurately counting carbohydrates due to varied fiber content

Plant-based foods vary widely in digestible versus total carbohydrate content due to fiber, requiring careful net-carb calculation for accurate insulin dosing.

A patient with type 2 diabetes and heart failure is being considered for an SGLT2 inhibitor. Which safety concern requires evaluation BEFORE initiating therapy?

Answer: eGFR below 20 mL/min/1.73 m², which may limit efficacy and safety

SGLT2 inhibitors lose glycemic efficacy at very low eGFR and carry risks of volume depletion and genitourinary infections that must be weighed against cardiovascular benefits.

A patient on SGLT-2 inhibitors asks if they can participate in a 3-day juice cleanse. The MOST important risk to address is:

Answer: Euglycemic diabetic ketoacidosis risk is increased with carbohydrate restriction on SGLT-2 inhibitors

SGLT-2 inhibitors increase ketone production, and carbohydrate restriction further elevates this risk, making euglycemic DKA a serious concern.

Insulin resistance in a hospitalized patient is MOST likely to increase insulin requirements due to:

Answer: Counter-regulatory hormone surges during physiologic stress

Physiologic stress triggers release of epinephrine, cortisol, glucagon, and growth hormone, causing marked insulin resistance and increased glucose production.

For a patient with diabetes and chronic kidney disease (CKD) stage 3b, dietary protein intake should be:

Answer: Restricted to 0.6–0.8 g/kg/day to slow CKD progression

ADA guidelines recommend reducing protein to 0.6–0.8 g/kg/day in non-dialysis CKD patients with diabetes to slow kidney disease progression.

Which risk management approach is MOST effective for BC ADM professionals when evaluating potential workplace hazards?

Answer: Proactive hazard identification and assessment

Proactive hazard identification and assessment allows professionals to identify and mitigate risks before incidents occur, which is far more effective than reactive approaches that only address problems after they happen.