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In reference to the JACC, The Basic Lipid Panel fails to identify up to_____% of those at risk for CVD
A.
20
B.
35
C.
50
D.
60
Correct Answer
D. 60
Explanation The Basic Lipid Panel is a common test used to assess an individual's risk for cardiovascular disease (CVD) by measuring their cholesterol levels. According to the Journal of the American College of Cardiology (JACC), this panel fails to identify up to 60% of those at risk for CVD. This means that even if someone's lipid panel results fall within the normal range, they may still be at risk for developing CVD. Therefore, relying solely on this panel may lead to a significant number of individuals being undiagnosed and not receiving appropriate preventive measures or treatment.
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2.
There were roughly__________ patients enrolled in the JACC study
A.
1.3 million
B.
130,000
C.
1 million
D.
2 million
Correct Answer
A. 1.3 million
Explanation The correct answer is 1.3 million. This implies that there were approximately 1.3 million patients who participated in the JACC study.
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3.
In the JACC, which of the following groups of patients had the highest rate of misclassified risk?
A.
B.
150-199 mg/dl TG’s
C.
100-149 mg/dl TG’s
D.
200-399 mg/dl TG’s
Correct Answer
D. 200-399 mg/dl TG’s
Explanation Patients with triglyceride levels of 200-399 mg/dl had the highest rate of misclassified risk in the JACC study. This suggests that individuals within this triglyceride range were more likely to be inaccurately categorized into a different risk group, potentially leading to incorrect treatment decisions or interventions. It is important to further investigate the reasons behind this misclassification and consider alternative methods to accurately assess cardiovascular risk in patients with elevated triglyceride levels.
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4.
There was more error seen in patients with LDL’s treated 70-99mg/dl than in those treated below 70mg/dl.
A.
True
B.
False
Correct Answer
B. False
Explanation The statement suggests that there were more errors observed in patients with LDL levels between 70-99mg/dl compared to those with LDL levels below 70mg/dl. However, the correct answer is False, indicating that this statement is not true. Therefore, there is no evidence to support the claim that there were more errors in patients with LDL levels between 70-99mg/dl.
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5.
In diabetics, the loss of lower-extremity sensation coupled with impaired peripheral vascular function is called______________ and can possibly lead to lower extremity ________________.
A.
Neuropathy, Amputation
B.
Nephropathy, Amputation
C.
Nerve damage, drop foot
D.
Microvascular disease, PVD
Correct Answer
A. Neuropathy, Amputation
Explanation In diabetics, neuropathy refers to the loss of lower-extremity sensation, which is caused by nerve damage. This can lead to a condition called amputation, where the affected individual may need to have a limb or a part of it surgically removed. The impaired peripheral vascular function in diabetics further contributes to the risk of developing amputation.
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6.
Type 2 diabetes accounts for approximately what percentage of all cases of diabetes in adults?
A.
55-60%
B.
35-40%
C.
90-95%
D.
20-30%
Correct Answer
C. 90-95%
Explanation Type 2 diabetes is the most common form of diabetes, accounting for approximately 90-95% of all cases in adults. This type of diabetes is characterized by insulin resistance, where the body's cells do not respond properly to insulin. Risk factors for type 2 diabetes include obesity, sedentary lifestyle, and genetic factors. It can often be managed with lifestyle changes, such as a healthy diet and regular exercise, although medication may also be necessary in some cases.
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7.
Risk factors for type 2 diabetes include all of the following except:
A.
Advanced age
B.
Obesity
C.
Smoking
D.
Physical inactivity
Correct Answer
C. Smoking
Explanation Smoking is not a risk factor for type 2 diabetes. While advanced age, obesity, and physical inactivity are all known risk factors for developing type 2 diabetes, smoking does not directly contribute to the development of the disease. However, smoking is associated with an increased risk of other health conditions such as heart disease, lung disease, and certain types of cancer.
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8.
35-60% of women with gestational diabetes are diagnosed with type 2 diabetes 10 to 20 years after deliver.
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is true because gestational diabetes is a temporary condition that occurs during pregnancy, but it increases the risk of developing type 2 diabetes later in life. Research shows that a significant percentage of women who had gestational diabetes will develop type 2 diabetes within 10 to 20 years after giving birth. This highlights the importance of monitoring and managing blood sugar levels in women with gestational diabetes to prevent the long-term development of type 2 diabetes.
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9.
Which form of diabetes is primarily linked to obesity?
A.
Type 1
B.
Type 2
C.
Type 3
D.
All of the above
Correct Answer
B. Type 2
Explanation Type 2 diabetes is primarily linked to obesity. Obesity leads to insulin resistance, where the body's cells do not properly respond to insulin. This causes the pancreas to produce more insulin to compensate, eventually leading to high blood sugar levels and the development of type 2 diabetes. Type 1 diabetes, on the other hand, is an autoimmune condition that is not directly linked to obesity. Type 3 diabetes is not a recognized form of diabetes, so it is not relevant to this question. Therefore, the correct answer is Type 2.
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10.
Which of the following is the most effective means of preventing or delaying the progression of pre-diabetes to type 2 diabetes?
A.
Taking medications to lower blood glucose.
B.
Eliminating sugar from the diet.
C.
Physical activity and weight loss
D.
All of these are equally effective.
Correct Answer
C. pHysical activity and weight loss
Explanation Physical activity and weight loss are the most effective means of preventing or delaying the progression of pre-diabetes to type 2 diabetes. Engaging in regular physical activity helps to improve insulin sensitivity and glucose uptake by the muscles, which can help to lower blood glucose levels. Additionally, losing weight can help to reduce insulin resistance and improve overall metabolic health. While taking medications to lower blood glucose may be necessary in some cases, it is not as effective as lifestyle changes such as physical activity and weight loss. Eliminating sugar from the diet alone is also not sufficient to prevent or delay the progression of pre-diabetes to type 2 diabetes.
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11.
Which of the following is not a complication of diabetes?
A.
Myocardial infarction
B.
Neuropathy
C.
Asthma
D.
Retinopathy
Correct Answer
C. Asthma
Explanation Asthma is not a complication of diabetes. Diabetes can lead to various complications such as myocardial infarction (heart attack), neuropathy (nerve damage), and retinopathy (damage to the blood vessels in the retina). However, asthma is a separate medical condition that affects the airways and is not directly related to diabetes.
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12.
In order to have a positive diagnosis of metabolic syndrome, you must have at least 3 or more of the 5 of which following parameters:
A.
Over 65, minority race, obesity, history of diabetes and other disease states (HTN, CVD, Fatty liver, and PCOS) present.
B.
Increased waist circumference (>102 cm [>40 in] for men, >88 cm [>35 in] for women); elevated triglycerides (≥150 mg/dl); low HDL cholesterol (
C.
Obesity, HTN diagnosis of a blood pressure >120/80mm/Hg, positive OGTT >200mg/dl, High LDL cholesterol above >100 mg/dl, triglycerides over 400 mg/dl.
D.
None of the above
Correct Answer
B. Increased waist circumference (>102 cm [>40 in] for men, >88 cm [>35 in] for women); elevated triglycerides (≥150 mg/dl); low HDL cholesterol (
Explanation The correct answer is the first option: Increased waist circumference (>102 cm [>40 in] for men, >88 cm [>35 in] for women); elevated triglycerides (≥150 mg/dl); low HDL cholesterol. These parameters are part of the diagnostic criteria for metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur together and increase the risk of heart disease, stroke, and type 2 diabetes. The presence of at least 3 of these parameters indicates a positive diagnosis of metabolic syndrome.
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13.
Type 1 diabetes accounts for approximately what percentage of all cases of diabetes?
A.
5-10%
B.
C.
90-95%
D.
50%
Correct Answer
A. 5-10%
Explanation Type 1 diabetes accounts for approximately 5-10% of all cases of diabetes. This means that out of every 100 people diagnosed with diabetes, only 5-10 of them will have type 1 diabetes. The majority of diabetes cases (90-95%) are actually type 2 diabetes, which is a different form of the disease. Type 1 diabetes is typically diagnosed in childhood or adolescence and is caused by an autoimmune reaction that destroys the insulin-producing cells in the pancreas. It requires lifelong insulin therapy for management.
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14.
The type of diabetes mellitus caused by lack of insulin is
A.
Type 1
B.
Type 2
C.
Adult-onset
D.
Non-insulin dependent
Correct Answer
A. Type 1
Explanation Type 1 diabetes mellitus is caused by a lack of insulin. In this type of diabetes, the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. As a result, the body is unable to produce enough insulin to regulate blood sugar levels. This type of diabetes typically develops in childhood or adolescence and requires lifelong insulin therapy to manage blood sugar levels. It is different from Type 2 diabetes, which is characterized by insulin resistance and often associated with lifestyle factors such as obesity and sedentary behavior.
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15.
Which of the following is not a warning sign or symptom of Type 1 diabetes?
A.
Loss of appetite
B.
Infrequent urination
C.
Weakness and fatigue
D.
Weight loss
Correct Answer
B. Infrequent urination
Explanation Infrequent urination is not a warning sign or symptom of Type 1 diabetes. Type 1 diabetes is characterized by symptoms such as loss of appetite, weakness and fatigue, and weight loss. However, infrequent urination is not typically associated with Type 1 diabetes. This symptom is more commonly associated with conditions such as dehydration or urinary tract infections. Therefore, infrequent urination is the correct answer as it does not fit the pattern of warning signs and symptoms of Type 1 diabetes.
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16.
Which of the following factor(s) do not increase your risk of having metabolic syndrome: CHECK ALL THAT APPLY
A.
Age
B.
Race
C.
Thyroid Disease
D.
Obesity
E.
Gestational Diabetes
Correct Answer
C. Thyroid Disease
Explanation Thyroid disease does not increase the risk of having metabolic syndrome. While factors such as age, race, obesity, and gestational diabetes can contribute to the development of metabolic syndrome, thyroid disease is not directly associated with it.
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17.
Diabetes can be damaging to the kidneys because
A.
Excess pressure can damage the glomeruli
B.
High levels of circulating glucose can cause glomeruli damage
C.
Insulin level can cause damage to the kidneys
D.
Diabetes does not cause kidney damage, kidney damage may cause diabetes
Correct Answer
B. High levels of circulating glucose can cause glomeruli damage
Explanation High levels of circulating glucose can cause glomeruli damage because when glucose levels are consistently high, it can lead to the formation of advanced glycation end products (AGEs). These AGEs can accumulate in the glomeruli, which are the tiny blood vessels in the kidneys responsible for filtering waste from the blood. The accumulation of AGEs can cause inflammation and damage to the glomeruli, impairing their ability to effectively filter waste and leading to kidney damage. Therefore, high levels of circulating glucose can be damaging to the kidneys in individuals with diabetes.
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18.
Which of the following is a conclusion drawn from the JACC paper?
A.
The Friedewald over estimates LDL when triglycerides climb above 400mg/dl
B.
Friedewald equation tends to underestimate LDL most when accuracy is most crucial
C.
Friedewald is good to use in all patients except for those at high risk
D.
Up to 60% of patients needed to be reclassified when comparing the VAP the BLP.
E.
B and D both
Correct Answer
E. B and D both
Explanation The conclusion drawn from the JACC paper is that the Friedewald equation tends to underestimate LDL cholesterol levels when accuracy is most crucial, and up to 60% of patients needed to be reclassified when comparing the VAP and BLP methods.
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19.
How many patients were in the JACC study?
A.
30,174
B.
1.3 million
C.
Over 2 million
D.
1.8 million
Correct Answer
B. 1.3 million
Explanation The JACC study included 1.3 million patients.
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20.
Under normal circumstances, endothelial cells are able to metabolize circulating blood glucose, providing the energy that the body needs to function. In hyperglycemia, however, too many glucose molecules in the blood cause endothelial cells to malfunction, damaging the body’s circulatory system and resulting in serious complications that can range from kidney failure and heart disease, to blindness.
A.
True
B.
False
Correct Answer
A. True
Explanation In hyperglycemia, there is an excessive amount of glucose in the blood, which can cause damage to the endothelial cells. These cells are responsible for metabolizing glucose to provide energy for the body. When there is an overload of glucose, the endothelial cells may not be able to properly metabolize it, leading to malfunction. This can result in damage to the circulatory system and various complications such as kidney failure, heart disease, and blindness. Therefore, the statement that endothelial cells malfunction in hyperglycemia, damaging the body's circulatory system and causing serious complications, is true.
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21.
Diabetes is characterized by _______________, an elevated concentration of sugar, or glucose, in the blood.
A.
Hypoglycemia
B.
Endothelial Damage
C.
Dysglemia
D.
Hyperglycemia
Correct Answer
D. Hyperglycemia
Explanation Hyperglycemia is the correct answer because it refers to an elevated concentration of sugar or glucose in the blood, which is a characteristic of diabetes. Hypoglycemia, on the other hand, refers to low blood sugar levels and is not consistent with the symptoms of diabetes. Endothelial damage and dysglemia are not directly related to the elevated blood sugar levels seen in diabetes.
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22.
CHECK ALL THAT APPLY: Diabetic Dyslipidemia is classified by which of the following abnormalities:
A.
High HDL
B.
Small Dense LDL pattern
C.
High Triglycerides
D.
Low HDL2 cholesterol
E.
All apply to diabetic dyslipidemia
Correct Answer(s)
B. Small Dense LDL pattern C. High Triglycerides D. Low HDL2 cholesterol
Explanation Diabetic dyslipidemia is a condition characterized by abnormal lipid levels in individuals with diabetes. Small dense LDL pattern refers to the presence of smaller and denser LDL particles, which are more atherogenic and increase the risk of cardiovascular disease. High triglycerides indicate elevated levels of triglycerides in the blood, which is commonly seen in diabetic dyslipidemia. Low HDL2 cholesterol refers to reduced levels of HDL2, a subtype of high-density lipoprotein that is cardioprotective. Therefore, all of these abnormalities apply to diabetic dyslipidemia.
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