BC ADM Complications Management 3

Question 1

A diabetic patient develops a foot ulcer with exposed tendon but no bone involvement. What is the Wagner classification grade?

Accepted Answer

Grade 2

Answer

Wagner Grade 2 involves a deep ulcer penetrating to tendon, capsule, or bone without osteomyelitis or abscess.

Question 2

Which cardiac condition is most strongly associated with diabetic autonomic neuropathy that increases mortality risk?

Accepted Answer

Prolonged QT interval

Answer

Prolonged QT interval from cardiac autonomic neuropathy predisposes to fatal ventricular arrhythmias and sudden cardiac death.

Question 3

When screening for diabetic retinopathy in a patient newly diagnosed with T2DM, how soon should the first dilated eye exam occur?

Accepted Answer

At the time of diagnosis

Answer

T2DM patients should have a dilated fundus exam at diagnosis because retinopathy may already be present due to prolonged undetected hyperglycemia.

Question 4

A patient with T1DM develops microalbuminuria. ACE inhibitor therapy is initiated. What is the primary mechanism of renoprotection?

Accepted Answer

Reduction in efferent arteriolar tone lowering intraglomerular pressure

Answer

ACE inhibitors preferentially dilate the efferent arteriole, reducing intraglomerular hypertension which drives glomerular injury.

Question 5

Which clinical feature best distinguishes peripheral arterial disease from diabetic peripheral neuropathy in a patient with foot pain?

Accepted Answer

Pain relieved by dependent positioning (hanging leg down)

Answer

Ischemic rest pain from PAD is relieved by dependency as gravity improves perfusion, unlike neuropathic pain which is positional-independent.

(BC ADM) Advanced Diabetes Management Certification Practice Test