BC ADM Complications Management 2

Question 1

A patient with T2DM presents with an eGFR of 28 mL/min/1.73m². Which medication should be discontinued to prevent lactic acidosis?

Accepted Answer

Metformin

Answer

Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to the risk of lactic acidosis from drug accumulation.

Question 2

Which finding on monofilament testing indicates loss of protective sensation in the diabetic foot?

Accepted Answer

Inability to feel the 10-g Semmes-Weinstein monofilament

Answer

Inability to detect the 10-g monofilament at plantar sites indicates loss of protective sensation and high ulcer risk.

Question 3

A patient with proliferative diabetic retinopathy is started on which first-line intravitreal treatment to reduce neovascularization?

Accepted Answer

Anti-VEGF agents

Answer

Anti-VEGF agents (e.g., ranibizumab, aflibercept) are first-line for proliferative diabetic retinopathy and diabetic macular edema.

Question 4

Which autonomic neuropathy manifestation most directly increases the risk of silent myocardial infarction in diabetic patients?

Accepted Answer

Cardiac autonomic neuropathy causing reduced pain perception

Answer

Cardiac autonomic neuropathy impairs pain signaling, allowing myocardial infarctions to occur without typical chest pain.

Question 5

A patient with diabetic nephropathy has a urine albumin-to-creatinine ratio of 450 mg/g. Which drug class is indicated to slow progression?

Accepted Answer

SGLT2 inhibitors

Answer

SGLT2 inhibitors (e.g., canagliflozin, dapagliflozin) have proven renoprotective effects independent of glucose lowering in CKD with albuminuria.

(BC ADM) Advanced Diabetes Management Certification Practice Test