The most common cause of peripheral

neuropathy is

(A) lead intoxication

(B) diabetes mellitus
(C) uremia
(D) polyarteritis nodosa
Enlargement of the peripheral nerves
throughout their course from spinal
cord and brainstem to the peripheral
termination, sparing the dorsal root
ganglia, is a description of

(A) alcoholic neuropathy

(B) Dejerine-Sottas disease
(C) diabetes mellitus neuropathy
(D) lead neuropathy
A 60-year-old patient with diabetes
developed a sensory neuropathy in both legs.
Her physician elected to confirm the
diabetic neuropathy with a nerve biopsy.
Which of the following findings would most
likely be present in the biopsy and
consistent with diabetic neuropathy?

(A) apple-green birefringence (congo red

stain)
(B) lymphocytic infiltrate
(C) onion bulbs
(D) thickened blood vessels
(E) Verocay bodies
A prominent feature of diabetic
neuropathy that is NOT seen in other
common neuropathies (e.g., Guillain-
Barre syndrome, uremic neuropathy,
alcoholic neuropathy) is involvement
(A) limited to motor nerves
(B) limited to sensory nerves with loss
of sensation
(C) limited to sensory nerves with pain
and parasthesias
(D) of autonomic nerves
(E) of both motor and sensory nerves
The fundamental pathologic lesion of
diabetes mellitus producing many
complications is

(A) lymphocytic infiltration of the

pancreatic islets
(B) necrotizing papillitis
(C) nodular glomerulosclerosis
(D) pyelonephritis
(E) small vessel disease
(microangiopathy)
The long-term complications of
diabetes mellitus are primarily the
result of

(A) vascular disease

(B) increased susceptibility to infection
(C) altered serum osmolality
(D) neurologic degeneration
The most common cause of death in
diabetics relates most closely to the
development of

(A) atherosclerosis
(B) amyloidosis
(C) necrotizing papillitis
(D) Kimmelstiel-Wilson disease
(E) peripheral neuropathy
The most important long-term effects
of diabetes mellitus result from
involvement of

(A) hepatocytes
(B) renal tubules
(C) neurons
(D) blood vessels
(E) pancreatic acinar cells
The most common cause of blindness in
diabetes is

(A) retrolental fibroplasia

(B) cataracts
(C) optic nerve atrophy
(D) proliferative retinopathy
Which of the following is the most
characteristic renal lesion of diabetes
mellitus?

(A) hyaline nodules in glomeruli

(B) endothelial and mesangial
hyperplasia
(C) flattened basophilic epithelial cells
(D) foot-process fusion
(E) epithelial crescent formation
Meticulous control of blood glucose
levels has been shown to be most
beneficial in diabetic

(A) cardiomyopathy
(B) complications of pregnancy
(C) glomerulosclerosis
(D) microangiopathy
(E) retinopathy
Effectiveness of an insulin therapy
regimen for diabetes mellitus over a
period of weeks can be determined by
measuring

(A) glycosylated hemoglobin (Hb A1C)

(B) oral glucose tolerance
(C) total serum cholesterol
(D) two hour post prandial blood sugar
level
(E) urine ketone levels
A 54-year-old man has been followed in your clinic
for 15 years for type 2 diabetes. To date he has
required therapy with diet and oral insulin-
releasing agents. Although he is only mildly
hyperglycemic on his clinic visits at three month
intervals, his glycosylated hemoglobin (A-1-C) level
has become consistently elevated over the last 2
or 3 years. He is at greatest risk for which of
the following complications of diabetes mellitus?

(A) diffuse glomerulosclerosis

(B) insulin-induced hypoglycemic coma
(C) ketoacidosis
(D) nonketotic hyperosmolar coma
A patient with diabetes mellitus presents to
the Emergency Room. She looks ill and has
a blood glucose level of 800 mg/dL. Her
blood pressure is normal. Which of the
following best describes her acid/base
status?
(A) metabolic acidosis with an increased
anion gap
(B) metabolic alkalosis with an increased
anion gap
(C) partially compensated metabolic acidosis
(D) partially compensated respiratory
acidosis
(E) respiratory acidosis
A 30-year-old patient presents with
nephrotic syndrome. Subsequently a
renal biopsy demonstrates uniformly
thickened peripheral capillary basement
membranes without electron dense
deposits. This combination of findings
suggests
(A) amyloidosis
(B) diabetes mellitus
(C) focal sclerosing glomerulopathy
(D) membranous glomerulonephritis
(E) minimal change disease
A 40-year-old woman has had a
chronic illness for 25 years, is partially
blind, and now presents with nephrotic
syndrome. She most likely has

(A) Berger disease

(B) membranous glomerulopathy
(C) minimal change disease
(D) nodular glomerulosclerosis
(E) post-infectious glomerulonephritis