BC ADM Pediatric Diabetes 3

Question 1

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

Accepted Answer

Evaluate timing and causes of hypoglycemic episodes

Answer

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

Question 2

Which complication screening should begin 5 years after diagnosis in a child with type 1 diabetes who is 10 years old or older?

Accepted Answer

Microalbuminuria and diabetic nephropathy screening

Answer

Annual microalbuminuria screening should begin 5 years post-diagnosis or at age 10, whichever comes first, to detect early diabetic nephropathy.

Question 3

A child with type 1 diabetes on a closed-loop insulin delivery system (artificial pancreas) has persistent hyperglycemia during exercise. The MOST likely cause is:

Accepted Answer

Activity mode was not activated, so the system did not reduce basal delivery

Answer

Most closed-loop systems have an 'activity' or 'exercise mode' that preemptively reduces insulin; failure to activate it results in relative insulin excess initially but can also reflect exercise-induced hyperglycemia from anaerobic activity.

Question 4

Which finding on urinalysis is MOST suggestive of type 2 diabetes rather than type 1 diabetes in an obese adolescent presenting with polyuria?

Accepted Answer

Glucosuria without ketonuria

Answer

Glucosuria without significant ketonuria favors type 2 diabetes, as insulin resistance (not deficiency) predominates and ketosis is less common at presentation.

Question 5

A 13-year-old with type 1 diabetes starts competitive swimming. Which strategy BEST addresses the risk of exercise-induced hypoglycemia?

Accepted Answer

Reduce rapid-acting insulin by 25–50% before swimming and have rapid carbohydrates available

Answer

Reducing the pre-exercise rapid-acting insulin dose by 25–50% and having carbohydrate sources available is the standard strategy for aerobic exercise in T1D.

(BC ADM) Advanced Diabetes Management Certification Practice Test

(BC ADM) Advanced Diabetes Management Certification Practice Test

BC ADM Pediatric Diabetes 3