BC ADM Fundamentals & Core Concepts 3

Question 1

Which enzyme is responsible for converting proinsulin to insulin in the pancreatic beta cell?

Accepted Answer

Prohormone convertases PC1/3 and PC2 along with carboxypeptidase E

Answer

Proinsulin is cleaved to insulin and C-peptide by prohormone convertases PC1/3 and PC2, with carboxypeptidase E removing residual amino acids.

Question 2

The Somogyi effect refers to which glucose pattern?

Accepted Answer

Rebound hyperglycemia following nocturnal hypoglycemia

Answer

The Somogyi effect (rebound hyperglycemia) occurs when nocturnal hypoglycemia triggers counterregulatory hormones, causing morning high glucose.

Question 3

In type 1 diabetes, the autoimmune destruction of beta cells is primarily mediated by which immune mechanism?

Accepted Answer

CD8+ cytotoxic T lymphocytes acting directly on beta cells

Answer

CD8+ cytotoxic T lymphocytes are the primary effectors of beta-cell destruction in type 1 diabetes, recognizing beta-cell autoantigens presented on MHC class I.

Question 4

Glucokinase (hexokinase IV) acts as the glucose sensor in pancreatic beta cells because it:

Accepted Answer

Has a high Km and is not saturated at normal glucose levels

Answer

Glucokinase has a high Km (~10 mM) so its activity rises proportionally with glucose concentration, allowing beta cells to sense physiologic glucose changes.

Question 5

Which statement best describes C-peptide's clinical utility in diabetes management?

Accepted Answer

It measures residual beta-cell function and helps distinguish insulin deficiency types

Answer

C-peptide is an indirect marker of endogenous insulin secretion, used to assess residual beta-cell function and differentiate type 1 from type 2 diabetes.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Fundamentals & Core Concepts 3