CDE Pathophysiology 3

Question 1

Which of the following best describes the pathophysiology of hyperosmolar hyperglycemic state (HHS)?

Accepted Answer

Relative insulin deficiency sufficient to prevent ketosis but insufficient to control glucose

Answer

In HHS, residual insulin secretion is enough to suppress hepatic ketogenesis but insufficient to prevent extreme hyperglycemia, resulting in severe hyperosmolality without significant ketoacidosis.

Question 2

The Somogyi effect refers to morning hyperglycemia caused by:

Accepted Answer

Rebound hyperglycemia following nocturnal hypoglycemia

Answer

The Somogyi effect describes rebound hyperglycemia occurring after nocturnal hypoglycemia triggers counterregulatory hormone release (glucagon, epinephrine, cortisol) that overshoots glucose correction.

Question 3

Peripheral insulin resistance in skeletal muscle primarily involves impairment of:

Accepted Answer

Insulin receptor tyrosine kinase activity and IRS-1 phosphorylation

Answer

Skeletal muscle insulin resistance centers on defective insulin receptor tyrosine kinase activation and downstream IRS-1 phosphorylation, impairing PI3K/Akt signaling and GLUT-4 translocation.

Question 4

In type 2 diabetes pathogenesis, the role of adipose tissue dysfunction includes:

Accepted Answer

Ectopic fat deposition and pro-inflammatory adipokine release

Answer

Dysfunctional adipose tissue in type 2 diabetes releases excess free fatty acids, pro-inflammatory cytokines (TNF-α, IL-6), and reduced adiponectin, contributing to systemic insulin resistance and inflammation.

Question 5

Counterregulatory hormone deficiency in long-standing type 1 diabetes most commonly manifests as:

Accepted Answer

Impaired glucagon response to hypoglycemia

Answer

After several years of type 1 diabetes, the glucagon counterregulatory response to hypoglycemia becomes severely blunted, contributing to hypoglycemia unawareness and increased severe hypoglycemia risk.

Certified Diabetes Educator Test Practice Test

Certified Diabetes Educator Test Practice Test

CDE Pathophysiology 3