Nokea
Madam Tan is newly diagnosed to have Type 2 DM. Her fasting plasma glucose is 12 mmol/L. Her blood pressure and fasting lipid profile are normal. She has been provided with patient education and advice on therapeutic life-style modification. Which is the most appropriate course of management for this lady?
- A. Commence her on combination therapy of three oral hypoglycaemic agents
- B. Motivate her to adhere with life-style modification
- C. Commence her on monotherapy of oral hypoglycaemic agent
- D. Commence her on combination therapy of two oral hypoglycaemic agents
Correct Answer: C
Rationale: New type 2, fasting 12 lifestyle's fresh, so metformin monotherapy starts, easing glucose without overload. Triple or dual oral's too much; insulin's for later; pushing lifestyle alone won't cut it yet. Nurses build this chronic base, balancing effort and meds.
You may also like to solve these questions
The thickening of the glomerular basal membrane in an early stage of diabetes mellitus is a consequence of which mechanism?
- A. AGE deposition
- B. Proteinuria
- C. Inflammation
- D. All mechanisms mentioned above
Correct Answer: A
Rationale: Early diabetic kidney AGEs glue GBM thick, not protein spill or inflammation yet. Nurses catch this, a chronic sugar scar.
Which of the following is NOT part of the histology of non-alcoholic steatohepatitis?
- A. Fatty infiltration in liver
- B. Fibrosis of liver
- C. Inflammatory infiltrates in lobules
- D. Cirrhosis
Correct Answer: D
Rationale: NASH histology includes steatosis (fatty infiltration), lobular inflammation, and fibrosis, per pathology definitions. Mallory bodies (intracellular inclusions) are classic but not universal. Cirrhosis is an advanced NAFLD outcome, not a defining NASH feature progression, not initial histology. This distinction aids physicians in staging chronic liver disease accurately.
Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary approaches are not as important as pharmacological approaches
- B. Carbohydrates have a greater satiating effect compared with proteins and fats, especially in individuals with prediabetes and obesity
- C. Intermittent fasting has consistently shown superior weight loss to very-low calorie and ketogenic diets as it is the easiest to adhere to
- D. Patient preference of dietary interventions plays a key part in adherence and ultimately weight loss and maintenance
Correct Answer: D
Rationale: Dietary approaches to obesity vary, but patient preference significantly influences adherence and long-term weight loss success, per behavioral studies making this true. Pharmacological approaches complement, not overshadow, diet. Proteins/fats are more satiating than carbohydrates, especially in prediabetes/obesity. Intermittent fasting's superiority isn't consistent adherence varies, not universally easier than ketogenic or very-low calorie diets. Preference drives sustainability, key for physicians tailoring chronic obesity interventions.
Endothelial dysfunction is one of the first steps in the development of atherosclerosis. Question: Which factor is NOT involved in endothelial dysfunction?
- A. Haemodynamic changes (e.g. hypertension)
- B. Inflammation
- C. Lipids
- D. Proteinuria
Correct Answer: D
Rationale: Endothelial flops pressure, inflammation, lipids kick it, proteinuria's kidney, not vessel start. Nurses spot this, a chronic dysfunction trio.
What is the cut-off of blood pressure for the diagnosis of hypertension that is recommended by MOH Clinical Practice Guideline?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/70 mmHg
- D. 140/90 mmHg
Correct Answer: D
Rationale: MOH guidelines hold hypertension at 140/90 mmHg, a conventional cutoff balancing sensitivity and specificity for diagnosis in primary care, aligning with global norms like WHO. Lower thresholds 120/70, 125/75, 130/70, 135/80 catch prehypertension or align with newer AHA standards, but MOH sticks to 140/90 for actionable clarity, triggering treatment to curb stroke or heart risks. This higher bar avoids overdiagnosis in resource-stretched settings, ensuring focus on clear disease, a practical call for managing chronic vascular load.