Chronic Disease Management Flashcards

A 50-year-old obese patient with newly diagnosed type 2 diabetes has no cardiovascular disease. Which medication offers the best combination of glycemic control and weight loss?

Answer: GLP-1 receptor agonist (semaglutide or liraglutide)

GLP-1 receptor agonists provide robust HbA1c reduction along with significant weight loss, making them ideal for obese type 2 diabetes patients.

Which lifestyle intervention has the strongest evidence for reducing cardiovascular mortality in patients with established coronary artery disease?

Answer: Cardiac rehabilitation program with structured exercise

Cardiac rehabilitation programs incorporating structured exercise have been shown in multiple trials to reduce cardiovascular mortality and hospitalizations in CAD patients.

A patient with hypothyroidism is stable on levothyroxine but reports fatigue and weight gain. TSH is 6.8 mU/L. What is the next step?

Answer: Increase the levothyroxine dose and recheck TSH in 6–8 weeks

An elevated TSH indicates under-replacement; increasing the levothyroxine dose with follow-up TSH in 6–8 weeks is the appropriate management.

Which drug class is preferred for hypertension management in a patient with diabetes and microalbuminuria?

Answer: ACE inhibitor or ARB

ACE inhibitors and ARBs are preferred in diabetic patients with microalbuminuria because they reduce intraglomerular pressure and slow progression of nephropathy beyond blood pressure control.

A 70-year-old patient with COPD has a resting oxygen saturation of 87% on room air. What is the appropriate oxygen therapy recommendation?

Answer: Long-term supplemental oxygen to maintain SpO₂ ≥90%

Long-term oxygen therapy is indicated when resting SpO₂ is ≤88%, as it has been shown to improve survival in severe hypoxemic COPD.

A patient with heart failure presents with worsening dyspnea and bilateral lower extremity edema. Current medications include carvedilol and lisinopril. What should be added?

Answer: Loop diuretic (furosemide) to relieve congestion

Loop diuretics are the cornerstone of symptom management for acute decompensation in heart failure, rapidly relieving pulmonary and peripheral congestion.

Which complication screening is uniquely required for patients with type 1 diabetes that differs from type 2 diabetes screening recommendations?

Answer: Celiac disease antibody screening (anti-tTG IgA)

Type 1 diabetes is associated with other autoimmune conditions, including celiac disease, which warrants periodic antibody screening not routinely performed in type 2 diabetes.