CDCES EXAM QUESTIONS AND ANSWERS 100% CORRECT LATEST UPDATE
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Course
CDCES
Institution
CDCES
CDCES EXAM QUESTIONS AND ANSWERS 100% CORRECT LATEST UPDATE
What is diabetic nephropathy? - Answer- When someone has frequent high blood sugars it can damage the nephron and glomerulus capillaries and cause proteins to leak into the urine from the blood (i.e. albuminuria)
High blood sugars ...
CDCES EXAM QUESTIONS AND
ANSWERS 100% CORRECT
LATEST 2024-2025 UPDATE
What is diabetic nephropathy? - Answer- When someone has frequent high blood
sugars it can damage the nephron and glomerulus capillaries and cause proteins to leak
into the urine from the blood (i.e. albuminuria)
High blood sugars also can cause scarring of the glomerulus, which can decrease their
ability to filter out waste products
(202)
What is diabetic retinopathy? - Answer- "Diabetic retinopathy is a highly specific
vascular complication of both type 1 and type 2 diabetes, with prevalence strongly
related to both the duration of diabetes and the level of glycemic control" (201)
What is diabetic neuropathy? - Answer- "The most common early symptoms are
induced by the involvement of small fibers and include pain and dysesthesia
(unpleasant sensations of burning and tingling). The involvement of large fibers may
cause numbness and loss of protective sensation (LOPS). LOPS indicates the presence
of distal sensorimotor polyneuropathy and is a risk factor for diabetic foot ulceration.
The following clinical tests may be used to assess small- and large-fiber function and
protective sensation:
Small-fiber function: pinprick and temperature sensation
Large-fiber function: vibration perception and 10-g monofilament
Protective sensation: 10-g monofilament" (201)
When should an ankle-brachial index test be performed? What follow up tests are
recommended for people with low ankle pressure? - Answer- "Ankle-brachial index
testing should be performed in patients with symptoms or signs of PAD."
"Urgent vascular imaging and revascularization should be considered in a patient with a
diabetic foot ulcer and an ankle pressure (ankle-brachial index) <50 mmHg, toe
pressure <30 mmHg, or a TcPO2 <25 mmHg" (201)
What is diabetic autonomic neuropathy? - Answer- "Major clinical manifestations of
diabetic autonomic neuropathy include hypoglycemia unawareness, resting tachycardia,
orthostatic hypotension, gastroparesis, constipation, diarrhea, fecal incontinence,
, erectile dysfunction, neurogenic bladder, and sudomotor dysfunction with either
increased or decreased sweating." (201)
What medications are recommended for the treatment of neuropathic pain? - Answer-
Pregabalin & duloxetine
Gabapentin is similar and has shown efficacy but is not FDA approved for this purpose
Opioids carry the risk of addiction and should be avoided
(201)
What medications are contraindicated for patients with diabetic gastroparesis? What
medications are used to treat it? - Answer- Opioids, anticholinergics, tricyclic
antidepressants, GLP1 RAs, pramlinitide, and DPP4 inhibitors
Metoclopramide/reglan for < 12 weeks
Erythromycin (short-term)
Domperidone (outside US)
Gastric electrical stimulation for patients with severe symptoms
(201)
When is insulin indicated in the inpatient setting? What is the target range for critically ill
patients? When is it appropriate to have more stringent goals? - Answer- When blood
glucose > 180 mg/dl
Target range 140-180 mg/dl
if patient can maintain 110-140 mg/dl without hypoglycemia, targets can be more
stringent
What are the recommendations for deintensification of insulin therapy in older adults? -
Answer- 1. Change basal insulin from bedtime to morning
2. Fasting glucose targets 90-150 mg/dl
3. Change premixed insulin to basal only and use 70% of total dose
4. Change mealtime insulin < 10 units to metformin or a secondary agent
5. For patients with mealtime dose > 10 units, cut insulin dosage by 50% and add
noninsulin agent
(SOC 2020)
What are the 6 elements of the Chronic Care Model? - Answer- 1. Proactive care
delivery delivery system design
2. Self management support
3. Decision support
4. Using clinical information systems for population based support
5. Community resources
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