BC ADM Fundamentals & Core Concepts 5

Question 1

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

Accepted Answer

Severe insulin resistance with hyperinsulinemia

Answer

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

Question 2

The 'glucose toxicity' concept in type 2 diabetes refers to:

Accepted Answer

Reversible impairment of beta-cell function and insulin sensitivity caused by chronic hyperglycemia

Answer

Glucose toxicity describes how chronic hyperglycemia itself reversibly impairs both beta-cell insulin secretion and peripheral insulin sensitivity, perpetuating the hyperglycemia.

Question 3

Which statement about the HbA1c test limitation is most clinically relevant for an advanced diabetes manager?

Accepted Answer

HbA1c may be falsely low in conditions that shorten red blood cell lifespan, such as hemolytic anemia

Answer

Conditions that shorten RBC lifespan (hemolytic anemia, hemoglobinopathies, recent transfusion) cause falsely low HbA1c by reducing red cell exposure time to glucose.

Question 4

Insulin secretion occurs in a biphasic pattern. The first phase primarily reflects:

Accepted Answer

Release of pre-formed insulin granules docked at the beta-cell membrane

Answer

The first-phase insulin spike (within 1–3 minutes of glucose rise) represents exocytosis of a readily releasable pool of pre-docked secretory granules.

Question 5

Latent autoimmune diabetes in adults (LADA) is distinguished from type 2 diabetes by:

Accepted Answer

Presence of islet autoantibodies (typically GAD65) and progressive beta-cell loss

Answer

LADA presents clinically like type 2 but is distinguished by islet autoantibodies (most commonly anti-GAD65) and inevitable progression to insulin dependence.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Fundamentals & Core Concepts 5