Minimum questions of metabolic disorders

  1. Choose the right answer!
  2. Laboratory criteria of diabetes mellitus: fasting glucose level is above 7.0 mmol/l. X
  3. Laboratory criteria of diabetes mellitus: fasting glucose level is above 7.8 mmol/l.
  4. Laboratory criteria of diabetes mellitus: fasting glucose level is above 6.1 mmol/l.
  5. Laboratory criteria of diabetes mellitus: glucose level after oral glucose tolerance test is above 11.1 mmol/l. X
  1. Choose the right answer!
  2. Type 1 diabetes mellitus develops usually in young and thin persons. X
  3. Type 2 diabetes mellitus develops usually in old and obese persons. X
  4. Background of type 2 diabetes is insulin resistance. X
  5. Cause of type 1 diabetes is the insufficient insulin production of beta-cells in

the Langerhans-islets. X

  1. Choose the right answer!
  2. In hypoglycaemic coma skin is wet and cold. X
  3. In hyperglycaemic ketoacidotic coma skin is dry and warm. X
  4. In hyperglycaemic coma blood pressure is decreasing. X
  5. In hyperglycaemic coma pulse is quick and easy to suppress.
  1. Choose the right answer!
  2. In hypoglycaemic coma blood pressure is normal or a little increased. X
  3. In hyperglycaemic ketoacidotic coma respiration is of Kussmaul-type. X
  4. In hypoglycaemic coma pulse is quick and plump. X
  5. In hyperglycaemic ketoacidotic coma there are often abdominal cramps present. X
  1. Choose the right answer! Characteristic symptoms of type 1 diabetes mellitus are the 6P symptom, which are:
  2. polyuria X
  3. polydipsia X
  4. polyphagia X
  5. pruritus X
  6. pyoderma X
  7. pyorrhea X
  8. Choose the right answer!
  9. By persons with obesity, moderate hyperglycaemia and type 2 diabetes mellitus first choice of treatment is reducing weight. X
  10. By persons with obesity, moderate hyperglycaemia and type 2 diabetes mellitus first choice of treatment is sulfonilurea.
  11. By persons with obesity, moderate hyperglycaemia and type 2 diabetes mellitus first choice of treatment is insulin therapy.
  12. By persons with obesity, moderate hyperglycaemia and type 2 diabetes mellitus first choice of treatment is reducing weight, which might be facilitated by acarbose and metformin. X
  1. Choose the right answer!
  2. Dawn phenomenon means that in the dawn-hours plasma glucose level is increasing because the production of the contrainsular growth hormone is the highest in that time period. X
  3. Dawn phenomenon means that in the dawn-hours plasma glucose level is decreasing because the production of the contrainsular growth hormone is the highest in that time period.
  4. Dawn phenomenon means that in the dawn-hours plasma glucose level is increasing because the production of the growth hormone is the lowest in that time period.
  5. Dawn phenomenon means that in the dawn-hours plasma glucose level is decreasing because the production of the contrainsular growth hormone is the highest in that time period.
  1. Choose the right answer!
  2. Somogyi-effect means that after the administration of a high dose of insulin, the increased production of the contrainsular hormones and the increased food intake due to hyperglycaemia increases plasma glucose level. X
  3. Somogyi-effect means that after the administration of a high dose of insulin, the decreased production of the contrainsular hormones and the decreased food intake due to hyperglycaemia increases plasma glucose level.
  4. Somogyi-effect means that after the administration of a high dose of insulin, the increased production of the contrainsular hormones and the increased food intake due to hyperglycaemia decreases plasma glucose level.
  5. Somogyi-effect means that after the administration of a high dose of insulin, the increased production of the contrainsular hormones and the decreased food intake due to hyperglycaemia increases plasma glucose level.
  1. Choose the right answer! Most often complications of diabetes mellitus:
  2. macroangiopathia X
  3. microangiopathia X
  4. neuropathia X
  5. nephropathia X
  6. diabetic food X
  7. lipodystrophia diabeticorum X
  1. Choose the right answer! Types of diabetic neuropathia can be:
  2. polyneuropathia X
  3. visceroneuropathia X
  4. mononeuropathia X
  5. nephro-neuropathia X
  1. Choose the right answer!
  2. Simmetric pain and torpidity, present on usually both legs, presenting often in the night is typical to diabetic polyneuropathia. X
  3. Diabetic polyneuropathia is a progressive process, which means that the alteration is getting continuously worse, and is irreversible. X
  4. Diabetic mononeuropathia affects most often brain nerves III, IV, VI, VII and ischiadic nerve. X
  5. Diabetic mononeuropathia is a regressive, non-irreversible process. X
  1. Choose the right answer! Representatives of visceral neuropathia are:
  2. gastroparesis X
  3. defecation disturbancies X
  4. micturation disturbancies X
  5. silent myocardial ischaemia and infarct X
  6. ceasing of physiological respiratory arrhythmia X
  1. Choose the right answer!
  2. Background of the developing of hyperglycaemic ketoacidotic coma is the increased liberation of the peripherial free fatty acids due to the lack of insulin and the production of keton-bodies due to the increased mitochondrial oxidation of the free fatty acids in the liver. X
  3. Background of the developing of hyperglycaemic ketoacidotic coma is the

decreased liberation of the peripherial free fatty acids due to the lack of insulin and the production of keton-bodies due to the decreased mitochondrial oxidation of the free fatty acids in the liver.

  1. Background of the developing of hyperglycaemic ketoacidotic coma is the

increased liberation of the peripherial free fatty acids due to the lack of insulin and the production of keton-bodies due to the decreased mitochondrial oxidation of the free fatty acids in the liver.

  1. Background of the developing of hyperglycaemic ketoacidotic coma is the

inreased liberation of the peripherial free fatty acids due to the increasing of the insulin level and the production of keton-bodies due to the increased mitochondrial oxidation of the free fatty acids in the liver.

  1. Choose the right answer!
  2. Background of hyperglycaemic hyperosmolar syndrome is that the body itself produces such an amount of insulin that inhibits both the production of free fatty acids in the periphery and the mitochondrial uptake and beta-oxidation of the fatty acids in the liver. X
  3. Background of hyperglycaemic hyperosmolar syndrome is that the body itself produces such an amount of insulin that increases both the production of free fatty acids in the periphery and the mitochondrial uptake and beta-oxidation of the fatty acids in the liver.
  4. Background of hyperglycaemic hyperosmolar syndrome is that the body itself produces such an amount of glucagon that inhibits both the production of free fatty acids in the periphery and the mitochondrial uptake and beta-oxidation of the fatty acids in the liver.
  5. Background of hyperglycaemic hyperosmolar syndrome is that the body itself does not produce such an amount of insulin that could inhibit either the production of free fatty acids in the periphery or the mitochondrial uptake and beta-oxidation of the fatty acids in the liver.
  1. Choose the right answer! Representatives of diabetic nephropathia can be:
  2. pyelonephritis X
  3. intercapillar glomerulosclerosis X
  4. necrotizing papillitis X
  5. nephrosis syndrome
  1. Choose the right answer!
  2. Bed-time insulin treatment means the administration of insulin in the evening hours around bedtime, while in the daytime oral antidiabetics are given. X
  3. During bed-time insulin treatment, the evening administration of insulin decreases the glucotoxic effect of the high plasma glucose made on the pancreatic beta-cells, making the daytime administered oral antidiabetics more effective and so they can normalize the plasma glucose level. X
  4. One of the most often complications of intensificated insulin treatment is hypoglycaemia. X
  5. Using insulin in type 2 diabetes mellitus can increase the patient’s body weight which makes an unfavorable effect on the insulin resistance. X
  1. Choose the right answer! Target values in the course of the treatment of diabetes mellitus:
  2. Hgb A1c value not to be beyond 6.5% X
  3. Blood pressure 130/80 mmHg X
  4. Triglicerid value below 1.7 mmol/l X
  5. HDL-cholesterin value to be above 1.2 mmol/l in women, above 1.01 mmol/l in men. X
  1. Choose the right answer! Criteria of metabolic syndrome:
  2. Obesity X
  3. Hypertension X
  4. Hypertrigliceridaemia X
  5. Decreased HDL-cholesterin X
  6. Insulin resistance, hyperglycaemia X
  1. Choose the right answer!
  2. Obesity means that BMI is above 30 kg/m². X
  3. Overweight means that BMI is between 25-30kg/m². X
  4. BMI is the sign of body mass index. X
  5. Body mass index is calculated by the division of the body mass with the square of body height given in meters. X
  1. Choose the right answer!
  2. Genetic factors play a significant role in the development of obesity. X
  3. The results of twin studies prove the role of genetic factors in obesity. X
  4. Besides of genetic background, environmental and lifestyle customs play role in the development of obesity. X
  5. In the development of obesity, the disproportion between the uptake and the egress of energy can be observed. X
  1. Choose the right answer! How changes the chance of the development of obesity in the following situations?
  2. If only one of the parents is obese, the chance of obesity is 50% at the child. X
  3. If both of the parents are obese, the chance of obesity is 80% at the child. X
  4. If none of the parents is obese, the chance of obesity is 10%at the child. X
  5. If both of the parents are obese, the chance of obesity is 20% at the child.
  1. Choose the right answer! For calculating the daily calory intake by women we use the following formula:
  2. daily calory intake = 700 kcal + 7x body weight X
  3. daily calory intake = 900 kcal + 7x body weight
  4. daily calory intake = 700 kcal + 10x body weight
  5. daily calory intake = 900 kcal + 10x body weight
  1. Choose the right answer! For calculating the daily calory intake by men we use the following formula:
  2. daily calory intake = 700 kcal + 7x body weight
  3. daily calory intake = 900 kcal + 7x body weight
  4. daily calory intake = 700 kcal + 100x body weight
  5. daily calory intake = 900 kcal + 10x body weight X
  1. Choose the right answer! During the ideal food intake, how does the percently distribution of the daily calory intake change between the main nutrient-components?
  2. carbohydrate (50-60%) X
  3. fat (30%) X
  4. protein (12-20%) X
  5. fat (36%)
  1. Choose the right answer!
  2. Burning of 1 g of fat liberates 9 kcal of energy X
  3. Burning of 1 g of carbohydrate liberates 4 kcal of energy X
  4. Burning of 1 g of protein liberates 4 kcal of energy X
  5. Burning of 1 g of alcohol liberates 7 kcal of energy X
  1. Choose the right answer!
  2. For constant weight loss, the daily calory intake of the patient must be decreased with 600 kcal. X
  3. The object of going on a diet is that the patient looses half kilogram per week, 2 kilograms per month. X
  4. By the implementation of the diet, beyond the culinary restriction, the daily physical activity must also be enhanced. X
  5. Frequency of physical activity must be at least 5 times 30 minutes weekly. X
  6. Intensity of physical activity must reach 60-70% of the maximal pulse rate during the whole period of the activity.
  7. Maximal pulse rate is due to the following formula: 220-age of the patient. X
  1. Choose the right answer!
  2. Gout developes as the consequence of the increased production and decreased excretion of urinary acid. X
  3. Goat affects mainly the distal joints. X
  4. Goat attack can occure also at a normal urinary acid level. X
  5. In the background of goat attack at normal urinary acid value, the cause can be the tissue hypoxia, pH abnormalities and crystallization of the urinary acid due to the depression of the temperature. X
  1. Choose the right answer! Typical for goat attack is:
  2. mostly affects metatarsophalangeal joints X
  3. throbbing pain X
  4. skin above the joint is red and warm X
  5. punctuate of the joint fluid contains urinary acid crystals X
  1. Choose the right answer! In the treatment of goat attack, the following therapy is recommended:
  2. Colchicin X
  3. NSAID X
  4. Milurit
  5. Probenicid
  1. Choose the right answer! For the prevention of goat attack, the following treatment is recommended:
  2. Milurit X
  3. Probenicid X
  4. Colchicin
  5. NSAID
  1. Choose the right answer!
  2. Primary hyperlipoproteinaemias mean lipid abnormalities on genetic background. X
  3. Secondary hyperlipoproteinaemias mean lipid abnormalities associated to other diseases or drug use. X
  4. Secondary hyperlipoproteinaemias mean lipid abnormalities on genetic background.
  5. Primary hyperlipoproteinaemias mean lipid abnormalities associated to other diseases or drug use.
  1. Choose the right answer! Normal values of the mean lipid parameters are:
  2. Cholesterol below 5.2 mol/l. X
  3. HDL-cholesterol above 1 mmol/l by men, above 1.2 mmol/l by women. X
  4. Triglicerid below 1.7 mmol/l. X
  5. Lp(a) below 30 mg/dl. X
  1. Choose the right answer! Characteristic properties of HDL:
  2. Transfers cholesterol from peripheric cells to the liver by the way of the reverse cholesterol transport. X
  3. Inhibits the oxidation of LDL. X
  4. Inhibits the expression of the adhesion molecules on the surface of the endothelial cells. X
  5. Anti-atherogene lipid fraction.
  1. Choose the right answer!
  2. Primary prevention trial means that the effect made on the clinical end points is studied on persons without definitive vascular disease, by lowering the cholesterol level by a special diet or drugs. X
  3. Secondary prevention trial means that the effect made on the clinical end points is studied on persons without definitive vascular disease, by lowering the cholesterol level by a special diet or drugs.
  4. Secondary prevention trial means that the effect made on the clinical end points is studied on persons with definitive vascular disease, by lowering the cholesterol level by a special diet or drugs. X
  5. Primary prevention trial means that the effect made on the clinical end points is studied on persons with definitive vascular disease, by lowering the cholesterol level by a special diet or drugs.
  1. Choose the right answer! At high-risk patients the target level of LDL is:
  2. LDL <2.6 mmol/l X
  3. LDL <3 mmol/l
  4. LDL <4 mmol/l
  5. LDL Í5.2 mmol/l
  1. Choose the right answer!
  2. From the cardiovascular aspect, a patient is considered as high-risk if the chance of an acute cardiovascular event in 10 years is more than 20%. X
  3. From the cardiovascular aspect, a patient is considered as moderate-risk if the chance of an acute cardiovascular event in 10 years is between 10 and 20%. X
  4. From the cardiovascular aspect, a patient is considered as low-risk if the chance of an acute cardiovascular event in 10 years is less than 10%. X
  5. From the cardiovascular aspect, a patient is considered as high-risk if the chance of an acute cardiovascular event in 10 years is more than 5%.
  1. Choose the right answer! Drugs used for lowering serum cholesterol level are the followings:
  2. statins X
  3. fitin acid derivates X
  4. acidum nicotinicum and derivates X
  5. ion-exchanging resins X
  1. Choose the right answer!
  2. Statins decrease mainly the cholesterol level. X
  3. Statins reach their cholesterol level changing effect by the way of the inhibition of the HMG-CoA reductase, which is the key enzyme of the intracellular cholesterol synthesis. X
  4. Fibrates expose their effect in the liver, through the PPAR-α receptors.
  5. Both the fibrates and the statins may cause myopathia and elevated liver enzymes as a side effect. X
  1. Choose the right answer! A patient with definitive coronary heart disease needs treatment if the lipid levels change in the following way:
  2. cholesterol > 4.5 mmol/l X
  3. cholesterol < 4.5 mmol/l
  4. LDL-cholesterol >2.5 mmol/l X
  5. LDL-cholesterol < 2.5 mmol/l
  6. Triglicerid <1.7 mmol/l
  7. HDL-cholesterol >1 mmol/l male
  8. HDL-cholesterol >1.2 mmol/l female.
  1. Choose the right answer! In patients with obesity and peripherial vascular disease or cerebrovascular disease the following target values are recommended:
  2. BMI<25 kg/m2 X
  3. adominal perimeter in male persons <94 cm X
  4. abdominal perimeter in female persons <80 cm X
  5. abdominal perimeter in female persons <88 cm
  1. Choose the right answer! For the treatment of obesity, the following drugs are recommended:
  2. orlistat (Xenical) X
  3. sibutramin (Reductil) X
  4. glibenclamid (Gilemal)
  5. glimepirid (Amaryl)
  1. Choose the right answer! For the development of metabolic syndrome the followings are extremely endangered:
  2. obese persons X
  3. hypertensive persons X
  4. persons with definitive vascular disease X
  5. diabetes mellitus in the family history X
  6. early myocardial infarct in the family history X
  7. gestational diabetes in the anamnesis
  8. large birth weight
  1. Choose the right answer! Lipid abnormalities in type 2 diabetes mellitus are the followings:
  2. hypertrigliceridaemia X
  3. decrease of HDL-cholesterol X
  4. increase of the proportion of small dense LDL X
  5. increase of the HDL
  1. Choose the right answer! Lipid abnormalities in chronic renal failure are the followings:
  2. hypertrigliceridaemia X
  3. decrease of HDL X
  4. increase of the cholesterol level X
  5. decrease of Lp (a)
  1. Choose the right answer! Lipid abnormalities due to liver disease:
  2. Presence of a pathological lipoprotein, lipoprotein X in the cholestasis. X
  3. In liver cirrhosis, endogen cholesterol synthesis and, consequently, cholesterol and triglicerid levels decrease. X
  4. In acut hepatitis, an increase of the triglicerid level can be observed. X
  5. In liver cirrhosis, endogen synthesis and consequently cholesterol and triglicerid level increase.
  1. Choose the right answer!
  2. Use of beta-blockers may decrease the level of HDL-cholesterol. X
  3. Use of thiazid-type diuretics in a large dose can decrease HDL and increase triglicerid level. X
  4. Cyclosporin increases cholesterol level.
  5. ACE inhibitors and calcium channel blockers does not affect lipid levels in an unfavorable way. X
  1. Choose the right answer!
  2. Heterozygote form of familiar hypercholesterinaemia occurs in one out of 500 people. X
  3. Familiar hypercholesterinaemia must be supposed if serum cholesterol level >6.5 mmol/l in the childhood and family history is positive for early cardiovascular events. X
  4. Familiar hypercholesterinaemia must be supposed if serum cholesterol level >7.8 mmol/l in an adult and family history is positive for early cardiovascular events. X
  5. Characteristic clinical symptoms of familiar hypercholesterinaemia are xantelasma palpebrarum, arcus corneae and tuberous xantoma. X
  1. Choose the right answer!
  2. Triglicerid levels above 10 mmol/l significantly enhance the risk of acute pancreatitis. X
  3. For lowering triglicerid levels fitin acid derivates and acidum nicotinicum derivates are primarily used. X
  4. High triglicerid level decreases HDL cholesterol level. X
  5. High triglicerid level increases HDL cholesterol level.
  1. Choose the right answer!
  2. Vitamin B1 (thiamin) is an important cofactor of numerous enzymes in the carbohydrate oxidation. X
  3. Lack of thiamin occurs principally in alcoholics. X
  4. Leading symptoms of the lack of thiamin are lack of appetite, muscle cramps, paresthesia, irritability. X
  5. For diagnosis of the lack of thiamin, the measurement of transkeolase activity in red blood cells and the measurement of thiamin excretion through the urine are recommended. Transketolase activity over 15-20% refers lack of thiamin. X
  1. Choose the right answer! It is characteristic for pellagra:
  2. caused by the lack of niacin X
  3. weakness, lack of appetite X
  4. irritability X
  5. mouth pain, glossitis X