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MCQ September 2024 (deadline: 22 Nov 2024)

1. Methods which may reduce the white coat effect of blood pressure measurement include the following EXCEPT:

A. Ambulatory blood pressure.
B. Home blood pressure.
C. Blood pressure measured by mercury column sphygmomanometer.
D. Automated office blood pressure.
E. Waiting area automated office blood pressure.

Answer: C.


2. Potential disadvantages of home blood pressure measurement for older people include the following EXCEPT:

A. Reporter bias.
B. Loss of white coat effect.
C. Difficulty for patients with cognitive impairment.
D. Difficulty for patients with visual impairment.
E. Difficulty for patients with neuromuscular impairment.

Answer: B.


3. According to the results of this study, wa-AOBP measurement?

A. Is similar to conventional AOBP.
B. Is lower than COBP.
C. Is lower than HBPM.
D. Is similar to ABPM.
E. Can replace HBPM.

Answer: B.


4. Which of the following statements regarding overbasalisation is FALSE?

A. Overbasalisation occurs when over-aggressive effort is attempted with basal insulin.
B. Overbasalisation leads to hypoglycaemia in fasting states.
C. Irregular meal times and increased physical activities predispose patients to overbasalisation.
D. Physicians should try to attain postprandial targets with basal insulin.
E. Overbasalisation is suspected when a patient on basal insulin has a high bedtime glucose and a low morning glucose, with a difference > 3.0mmol/L.

Answer: D.


5. Which of the following statements regarding type 2 diabetes mellitus (T2DM) insulin treatment is FALSE?

A. ADA recommends initiation of basal insulin when HbA1c remains uncontrolled after 3 months of triple combination of oral hypoglycaemic agents (OHAs).
B. The first target after insulin initiation should be to achieve optimal HbA1c levels.
C. One should refrain from insulin up titration whenever nocturnal hypoglycaemia is reported.
D. Approximately half of patients achieve HbA1c ≤ 7% with insulin doses in the range of 40 - 70 unit/day.
E. Patient should continue on 2 concomitant OHAs at most when on basal insulin.

Answer: B.


6. When should a primary care physician consider starting a patient on basal insulin therapy?

A. Only when the patient has a HbA1c level above 10%.
B. When lifestyle modifications and oral medications are insufficient to control blood glucose levels.
C. When the patient is experiencing severe hypoglycaemia with oral medications.
D. When a patient is newly diagnosed with diabetes.
E. To control postprandial glucose levels.

Answer: B.


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