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Erectile dysfunction icd 10: How to treat erectile dysfunction

Erectile dysfunction icd 10 : Treatment and solution

erectile dysfunction

(toc) Table of Contents

Introduction of Erectile Dysfunction

Disclaimer: This article may contain texts or images that are not suitable for people below 18 years. If your’re below 18 years leave this article and go to ▶homepage.
Erectile dysfunction is one of the most common male sexual dysfunction in modern world are facing now.
It is the inability to attain or sustain an erection satisfactory for sexual intercourse including sufficient hardship or time.
Most erectile dysfunction is most commonly related to vascular (blood vessels), neurologic(brain or nerves), psychological(thought or mental status), and hormonal disorders(mostly make hormones like testosterone); use of a medication can also be a significant cause.
Evaluation typically includes screening for underlying disorders and measuring testosterone levels in blood.
Treatment options include oral phosphodiesterase inhibitors, intraurethral suppositories, intracavernosal injections, vacuum erection devices, and surgical implants.
These topics will be discussed separately below.

Causes of erectile dysfunction

There are basically two types of erectile dysfunction:
  • Primary erectile Dysfunction: a man has never been able to attain or sustain erection
  • Secondary erectile dysfunction: a man has previously been able to attain or sustain erection but now he is unable to do so.

Based upon the above types, the causes of ED can be listed as below:

  1. Vascular causes/disorders
  2. Neurologic causees/disorders
  3. Hormonal causes
  4. Psychological/Psychiatric causes
  5. Systemic illness related causes

Vascular cause of erectile dysfunction:

Out of these, Vascular cause is the most common cause of erectile dysfuntion.
Atherosclerosis, is the major vascular cause to be noted. Other include smoking, endothelial dysfunction, diabetes and autoimmune vasculitis.
Age is the important factor that plays great role side by side on this.
Generally low testosteone level from other hormonal dysorder also causes penile vascular abnormality and hence ED.

Neurological causes of erectile dysfunction include:

  1. Stroke
  2. Seizures
  3. Multiple sclerosis
  4. neuropathies
  5. spinal cord injuries
    1. Diabetic neuropathy
    2. Surgical damage of nerves
  6. Complication of pelvic surgeries
  7. cancer surgeries
  8. Cystectomy(removal urinary bladder)
  9. TURP (surgery of prostate)
how to increase blood flow to groin

Hormonal disorders of erectile dysfunction include :

  1. primary hypogonadism
  2. secondary hypogonadism
  3. medicaltion like anti andogens

Other causes of erectile dysfunction:

  1. Pelvic radiation
  2. Structural disorders of penis like pyronie disease
  3. prolonged perineal pressure
  4. Perineal trauma
  5. sickle cell disease

Medication 

Medication like cocaine use, alcohol, trazodone and inta cavernous injection of multiple injection may also c a use penile tissue destruction and the erectile dysfuncton.
Vasectomy (copyright: mayoclinic)

Can Vasectomy and permanent male sterilization cause erectile dysfunction ?

No, vasectomy cannot cause erectile dysfunction. The explanation is: it blocks the way from which sperms come out by mixing with semen but it doen not reduce serum testosterone level. 
The testosterone that is produced in testicles is released into the blood but not into the semen. Hence this will have no effect on serum testosterone level hence in sexual function as well.

Diagnosis of Erectile Dysfunction

Diagnosis of erectle dysfunction is done clinically. For further confirmation and to rule out other causes further tests cn be done on the basis of clinical judgement.
  1. Clinical evaluation
  2. Screening for depression and mental illnesse
  3. Serum testosterone level
Patient can also be evaluated for the vascular, neurological and systemic illnesses as well.
Sometimes partner sexual dusfunction can also be takie ninto account to rule out the cause related to partner compliance.
Examination is also focused to pelvic, genital and systemic evluation based on history given by the patient.
Patient should be throughly evaluated for hypogonadism and pyronie disease.
Laboratory testing can be done from testosterone level to LH and prolactin as well.
Screening should be done for occult diabetes, dyslipidemia, hyperprolactinemia, thyroid disorders, cushing syndrome as well.
Penile vascular study can be done using vaoactive agents and ultrasound.
Nocturnal penile erection episode can also be measured/monitored to rule out the disgnosis.

Treatment options for Erectile Dysfunctions

Various treatment approaches can be taken to treat erectile dysfunction. the approach can be summarised as below.

  1. Treatment of underlying cause
  2. Drugs
  3. Psychotherapy
  4. vaccum devices
  5. Self injectable drugs
  6. penile prosthesis 
If the patient has any of the following underlying systemic illnesses like diabetes, prolactinsecreting pituitary tumor, hypogonalism, pyronie disease appropriate treatment should be started immediately. Thyroid disease,  dislipidemia, cushing syndrome should also be treated appropriately.
Several vitamins and herbal medicine are claimed to be effective for erectile dysfunction but are not proven yet to be effective.
indian implant for erectile dysfunction

The most common drugs used to treat are 5-phosphodiasterase inhibitors like sildenafil, tadalafil etc. These drugs are available over the counter in several countries. These medications are taken orally.

If these treatment are not working, intracavernous or intraurethral prostaglandin E1, vaccum device, surgical implantation or penile prosthesis can be tried and are the final line of the treatment in case of erectile dysfunction.

What are respiratory fluoroquinolones and what are their uses?

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Respiratory Fluoroquinolones: Introduction, Uses and Side Effects

Respiratory fluoroquinolone are a class of antibiotics that are used to treat various kind of the bacterial infections, including those affecting the respiratory system.

These medications work by mechanism of  inhibiting the growth of bacteria, ultimately leading to their death.

Structure of ciprofloxacin

What are the  Fluoroquinolones?

Fluoroquinolones are a group of synthetic antibiotics that were first developed in the 1960s. These antibiotics are widely used now a days to treat various kind of infections. 

They have a broad spectrum of activity, which means they can target a wide range of bacteria of different groups. This makes them highly valuable in treating infections caused by both gram-positive and gram-negative bacteria.

With widespread use, antimicrobial resistance to fluoroquinolones has grown.

What Respiratory Infections are Treated with Fluoroquinolone?

Respiratory fluoroquinolone are commonly prescribed to treat a variety of respiratory infections, including:

  • Pneumonia: A lung infection that can be caused by bacteria, viruses, or fungi. If it is bacterial fluoroquinolone can be used.
  • Chronic bronchitis: A condition characterized by persistent cough with mucus production.
  • Sinusitis: Inflammation of the sinuses, often caused by bacterial infection.
  • Community-acquired pneumonia (CAP): Pneumonia acquired outside of a healthcare setting.
  • Hospital-acquired pneumonia (HAP): Pneumonia that develops during a hospital stay.
  • Ventilator-associated pneumonia (VAP): Pneumonia that develops in patients who are on a ventilator.

How do Fluoroquinolones Work?

Fluoroquinolones interfere with the DNA replication of bacteria. They target enzymes called DNA gyrases and topoisomerases, which are essential for bacterial growth and survival. By inhibiting these enzymes, fluoroquinolones prevent bacteria from replicating their DNA and ultimately cause them to die.

Common Respiratory Fluoroquinolones

Several fluoroquinolones are commonly used to treat respiratory infections while others are less useful for bacteria that acauses upper and lower respiratory tract infection. Some of the most well-known examples include:

  • Ciprofloxacin

    • DOSE is 500 mg orally twice daily or 400 mg iv twice daily for adults

  • Levofloxacin

    • Dose is 500-750 mg orally or iv daily

  • Moxifloxacin

    • Dose is 400 mg daily for 5-10 days 

  • Gemifloxacin

    • 320 mg once daily for 5 days

  • Ofloxacin

    • 200 mg once dailt for uti and 400 mg once dailly for pneumonia / respiratory infections

Benefits of Fluoroquinolones over other antibiotics

Fluoroquinolones offer several benefits, including:

  • Broad-spectrum activity: They can target a wide range of bacteria.
  • High bioavailability: They are well-absorbed by the body.
  • Long half-life: They remain in the body for a long time, allowing for once-daily dosing.
  • Effective against resistant bacteria: They can be effective against some antibiotic-resistant bacteria.
    For example levofloxacin has great antipseudomonal activity where pseudomonas is highly resistant gram negative anaerobe which is resistant to most of the penicillins and cephalosporing.

Note: Other antipsuedomonal antibiotics include: Piperacillin + tazobactum, third /forth generation cephalosporin like cefepime or ceftazidime, fluoroquinolones like levofloxacin, carbapenems, and monobactams.

Fluoroquinolones are also particularly inportant to use in case of  cartilage infections like chondritis or malignant otitis externa especially ciprofloxacin as this antibiotic has good cartilage penetration the cartilage to reach the target site.

Potential Side Effects of fluoroquinolone group of drugs

While fluoroquinolones are generally well-tolerated, they can cause some side effects. These may include:

  • Gastrointestinal disturbances: Diarrhea, nausea, and vomiting.
  • Nervous system effects: Headache, dizziness, and insomnia.
  • Joint pain: Tendinitis and tendon rupture. Achilles tendon rupture is most common
  • Allergic reactions: Rash, itching, and difficulty breathing.

Important Considerations for giving Fluoroquinolone

It’s important to note that fluoroquinolones should only be used under the guidance of a healthcare professional.

They should not be self-medicated. Additionally, overuse of fluoroquinolones can contribute to antibiotic resistance, making it more difficult to treat infections in the future.

As resoiratory fluoroquinolones are also the second line antitubercular drugs they should be cautiously used in part of the world where tuberculosis is common. 

Also the possibility of tuberculosis should be ruled out beforehand either by sputum Acid fast staining (AFB staining) or Gen-eXpert whichever modality is available in high risk patients. 

Conclusion

Respiratory fluoroquinolones are valuable medications for treating various bacterial infections of the respiratory system.

Fluoroquinolones act by inhibiting DNA dependent RNA synthesis in the bacterial cells.

They offer several benefits, including broad-spectrum activity and effectiveness against resistant bacteria. However, it’s essential to use them appropriately and under medical supervision to minimize side effects and prevent the development of antibiotic resistance.

CBC- Complete clood count : Normal range in Nepali

What does CBC mean in medical?

CBC stands for Complete blood count. Occasionally it is also called Full blood count or Total count/Differential ccount. In the CBC total number of blood cells i.e., WBC ( and its subtypes), RBC and platelets per unit volume are measured. Full blood count may occasionally include Hemoglobein, Hematocrit and other RBC parameters as well. 
Following are the measurements done in the total blood count. 

What is measured in cbc blood test

What is measured in cbc panel?

  • WBC count
  • Differential WBC count
    • Neutrophil
    • Lymphocyte
    • Monocyte
    • Basophil
    • Eosonophil
  • Hemoglobein
  • RBC
  • Hematocreit or Pack cell volume (PCV)
  • Mean cell volume
  • Mean cell hemoglobein
  • Mean cell hemoglobein concentration
Some labs may also include other less commonly done tests. 
The number of parameters provided by the CBC report may also depend upto the machine used for measurement.

CBC test price

Price of CBC test varies from 150 rupees to 600 rupees in Nepal. That is $1 to $5. But this test may be even cheaper or expensive in various health facilities and hospitals. You will get cheap in Government hospitals while expensive in private hospitals. I have noticed hospitals charging upto 800 rupeed for the test here in Nepal.   
Platelets floating in blood vessel

CBC blood test price in nepal: Judgement

The range of CBC price tho varies, very expensive rate is not logical. Though they claim that they carge for the facility, the reliability and the quality of equiment they use for test. You always have option to choose the facility of your affordibility. 
Top government hospitals in kathmandu TU teaching hopital, Patan hospital, Bir hospital and Civil hospital charge less than 350 rupees for CBC test. 
Types of WBC in CBC

CBC test price in nepal: How to choose?

If you’re searching for very high reliability and cheap price choose the above mentioned Government hospitals otherwise you can do it anywhere. Some low quality facility may not perform it well so be careful. 

What to expect while getting your CBC done?

  • You need to get your vein pricked
  • blood should be collected in purple vial or EDTA vial
  • It may take upto 3 hours for CBC report to get 
  • Some time if technical problem occur you may need to repeat test
  • If any findings are abnormal your doctor may order other tests as well
RBC

Normal CBC values for healthy adult

  • WBC
  • RBC
  • HB
  • MCV
  • MCH
  • MCHC
  • HCT
  •  Erythrocyte count 
    • Male: 4.3–5.9 million/mm3
    •  Female: 3.5–5.5 million/mm3
  •  Erythrocyte sedimentation rate (Westergen) 
    • Male: 0–15 mm/hr
    •  Female: 0–20 mm/hr
  •  Hematocrit 
    • Male: 41–53%
    •  Female: 36–46%
  •  Hemoglobin, blood 
    • Male: 13.5–17.5 g/dL
    •  Female: 12.0–16.0 g/dL
  •  Hemoglobin, plasma < 4 mg/dL < 0.62 µmol/L
  •  Leukocyte count and differential
    •  Leukocyte count 4,500–11,000/mm3
      •     Segmented neutrophils 54–62%
      •     Band forms  3–5%
      •     Eosinophils 1–3%
      •     Basophils 0–0.75%
      •     Lymphocytes 25–33%
      •     Monocytes 3–7%
  • Mean corpuscular hemoglobin 25–35 pg/cell
  • Mean corpuscular hemoglobin concentration 31%–36% Hb/cell 
  • Mean corpuscular volume 80–100 µm3 80–100 fL
  • Partial thromboplastin time (activated) 25–40 sec 
  • Platelet count 150,000–400,000/mm3 
  • Prothrombin time 11–15 sec
  • Reticulocyte count 0.5–1.5% of RBCs 



Do you want to get your CBC or full body checkup done?

Drug Banned in Nepal with Reason 2024!

What are the drugs banned in Nepal and who banned them for what?

Table of Contents(toc)
Molecular structure of a Drug Named Paracetamol or Acetaminophen also called Tylenol

Introduction

Drug banning is common worldwide. The specific drug or drug combination if found not useful, harmful, low quality or misused the regulation agency of the country may ban particular drug or drug formulation or combination as necessary.
It is illegal to buy, sell, recomment or use such drug in any situation in the country before ban is released or the regulatory body has provided specific written permission for special use situation of the drug.

Which Drugs are banned in Nepal?

There are plentyof drugs banned in Nepal for various reasons. 

These drus are not allowed to sale, prescribe and distribute in Nepal and doing such is a criminal activity and is punishable.

Government of Nepal has banned the folowing medicines for production,
sale-distribution and import.

Who is responsible for drug regulation in Nepal?

DDA is responsible for banning drugs in Nepal as a governing authority of Nepal.
drug banned in nepal with reason

The reason for drug ban include

  1. Interaction
  2. Possibility of poisoning 
  3. Possibility of overdose
  4. Ineffectiveness
  5. Potential banned status of one drug or component

Here is list of banned drugs and combinations in Nepal

Drug banned in nepal with reason

The ban should not be applicable to the veterinary products
and topical preparations.
The reason for drug banned in nepal with reason is  Interaction Possibility of poisoning, Possibility of overdose, Ineffectiveness, Potential banned status of one drug or component.



Hemorroids and hydrocele: treatment and complications ppt 2024

Hemorroids and hydrocele: treatment and complications ppt 2024

Table of Contents(toc)

Introduction

Hemorrhoids are collection of the swollen vein, which are part of arteriovenous connection through the GI system, in Anal region are called Hemorrhoids.
They present the symptoms like pain, bleeding, itching, discharge, constipation, soiling of garments etc.

Introduction to hydrocele

hydrocele image

Hydrocele is collection of Fluid (peritoneal) in the scrotum especially between the visceral and peritoneal layer of Tunica vaginalis. 

Presentation on Hemorrhoids and Hydrocele

Thank you for reading.
Feel free to comment your opinion down nbelow.

Syllabus: Bachelor Level Common Entrance Examination BL CEE

Syllabus: Bachelor Level Common Entrance Examination

(toc)Table of Contents


Introduction to MEC

राष्ट्रिय चिकित्सा शिक्षा ऐन २०७५ले व्यवस्था गरे बमोजिम, चिकित्सा शिक्षाको क्षेत्रमा राज्यको लगानी अभिवृद्धि गर्दै, चिकित्सा शिक्षालाई नेपालको राष्ट्रिय आवश्यकता अनुरुप विकास गरी, चिकित्सा शिक्षाको नियमनलाई एकीकृत तथा चुस्त बनाउन, चिकित्सा शिक्षा सम्बन्धी शिक्षण संस्थाको स्थापना र सन्चालन सम्बन्धी कार्यलाई व्यवस्थित गर्न तथा चिकित्सा शिक्षामा गुणस्तर, पेशाधर्मिता, संस्थागत जवाफदेही, भौगोलिक सन्तुलन र सामाजिक न्याय कायम गरी, विपन्न लगायत सबै विध्यार्थीहरुको समान पहुँच सुनिश्चित गर्नकालागि, चिकित्सा शिक्षा सुधार गर्ने सम्बन्धमा विभिन्न समयमा गठित आयोग, समिति तथा कार्यदलको प्रतिवेदनको मर्म र भावना समेतलाई दृस्टीगत गरी, चिकित्सा शिक्षा आयोगको स्थापना र संचालन भएको हो। ऐनले चिकित्सा शिक्षालाई यसरी परिभाषित गरेको छ – “चिकित्सा शिक्षा” भन्नाले स्वास्थ्य पेशा सम्बन्धी सबै विधा र तहका शिक्षा (हेल्थ प्रोफेसनल एजुकेसन) सम्झनु पर्छ।

What is CEE for bachelor level?

CEE, in the context of medical undergraduate entrance exams, refers to the Common Entrance Examination used for admissions to programs such as MBBS, BDS, and nursing. This exam assesses candidates’ knowledge and aptitude in subjects like Biology, Chemistry, and Physics, which are crucial for medical and health-related fields. 

Click here if you are looking for PG CEE Syllabus instead.
It is designed to evaluate the understanding of fundamental concepts, problem-solving skills, and critical thinking abilities necessary for success in medical education. The results of the CEE are used by medical and nursing colleges to select students for their programs, ensuring that admitted candidates are well-prepared for the rigorous study and training required in these professions.

Go to download pdf here

Multiple choice questions series 5 : Surgery MCQ for HA CMA ANM 2024

MCQ for medical students and nhpc license examination preparation 5

Table of Contents(toc)

Here  I have prepared 30 MCQs for your practice and we can discuss the
questions in the class or sparately.

Introduction

Please go through the MCQs and solve them.
These questions are very important for you and your upcoming exams.

These are euqually important for HA CMA ANM and other medical and
paramedical exams as well.
Please refer to any standard textbooks for answers if u cannot directly
contact me.
I have provided my contact details in the website for further.

MCQ for PCL Nursing  level free

MCQ series 4 for PCL level Health exams preparation and study tips 2024

MCQ for medical students and nhpc license examination preparation set: 4

Table of Contents(toc)

Introduction

I hope you are doing well and reading this. As you are aware, we will be using
Google Forms to administer an upcoming multiple-choice test. I’m writing to
respectfully ask that you take the test and do your best.

Why to Practice MCQ

It is quick and easy to gauge your level of subject knowledge by taking
the test using Google Forms. As many tests are now taken online, it’s also a
fantastic chance to practice test-taking techniques.

Before you begin

Before beginning the test, please be sure you read and comprehend the
instructions and to have a reliable internet connection. Please do not
hesitate to contact me for help if you run into any technical issues.

MCQ for PCL level google forms quiz mode

 

Cancer & Lung Disease

  1. Most common type of cancer worldwide leading to death is:

    • Lung
    • Breast
    • Thyroid
    • Prostate

  2. Most common preventable cause related to lung cancer:

    • Alcohol consumption
    • Pollution
    • Cigarette smoking
    • Red meat consumption

  3. Most common variety of bronchial carcinoma:

    • Adenocarcinoma (30%)
    • Small cell (20%)
    • Squamous cell (35%)
    • Large cell (15%)

  4. Hoarseness of voice in carcinoma of lung is due to compression of which nerve?

    • Vagus nerve
    • Recurrent laryngeal nerve (left)
    • Glossopharyngeal nerve
    • Hypoglossal nerve

  5. A patient with a 3-month history of cough, chest pain, and hemoptysis presents with shortness of breath. X-ray shows a large left-sided effusion, and the fluid appears hemorrhagic. What is the most probable diagnosis?

    • Pleural TB
    • Pulmonary tuberculosis
    • Carcinoma of lung
    • Heart failure

Renal Diseases & Urinary System

  1. Nephrotic range proteinuria is defined as:

    • 1 mg in 24 hr

    • 1 g in 24 hr

    • 3 mg in 24 hr

    • 3 g in 24 hr

  2. Post-streptococcal glomerulonephritis occurs how long after a streptococcal throat infection?

    • 1-2 weeks
    • 2-4 weeks
    • 6-10 weeks
    • After 3 months

  3. Post-streptococcal glomerulonephritis occurs how long after a streptococcal skin infection?

    • 1-2 weeks
    • 2-4 weeks
    • 6-10 weeks
    • After 3 months

  4. Which group of Streptococcus is mainly responsible for PSGN?

    • Group A beta-hemolytic
    • Group B beta-hemolytic
    • Alpha-hemolytic streptococcus
    • All of the streptococci

  5. Color of urine in nephritic syndrome is:

    • Cola-colored
    • Cloudy
    • Dark yellow
    • White

  6. Which feature differentiates nephrotic syndrome from nephritic syndrome?

    • Proteinuria
    • Edema
    • Hypertension
    • Deranged renal function

  7. Which class of antihypertensive is antiproteinuric and hence useful in nephritic syndrome?

    • Calcium channel blockers
    • Beta-blockers
    • ACE inhibitors
    • Diuretics

  8. Most common cause of nephrotic syndrome is:

    • Minimal change disease (90%)
    • Focal segmental glomerulosclerosis
    • Membranoproliferative glomerulonephritis
    • Membranous nephropathy

  9. Which of the following is NOT a classical feature of nephrotic syndrome?

    • Heavy proteinuria
    • Hypoalbuminemia
    • Hypolipidemia
    • Lipiduria

  10. Edema in nephrotic syndrome is due to:

    • Increased hydrostatic pressure
    • Decreased oncotic pressure in blood
    • Increased oncotic pressure in interstitial side
    • Inflammation of soft tissue

Urinary System & UTI

  1. Average length of female urethra is:

    • 3 cm
    • 4 cm
    • 5 cm
    • 6 cm

  2. Why is the incidence of UTI higher in females?

    • They are more immune-compromised
    • Short urethra
    • Presence of variety of bacteria in vulva
    • Lack of hygiene

  3. Most common pathogen group causing UTI:

    • Fungus
    • Protozoans
    • Gram-positive bacteria
    • Gram-negative bacteria

  4. Most common cause of UTI:

    • E. coli
    • Klebsiella spp
    • Proteus spp
    • Pseudomonas spp

  5. Renal angle tenderness is positive in:

    • Nephritic syndrome
    • Pyelonephritis
    • Ureteric calculus
    • Bladder outlet obstruction

  6. Antibiotics for UTI should be given for:

    • 15-20 days
    • 3-5 days
    • 8-10 days
    • 7-14 days

  7. Most common composition of renal calculus:

    • Oxalate
    • Uric acid
    • Cystine
    • Triple phosphate

  8. Staghorn calculus is:

    • Chemical composition of calculus
    • Calculus with spikes
    • A big calculus
    • Large calculus taking the shape of renal pelvis

  9. The calculus that can be seen on X-ray (radio-opaque) is:

    • Oxalate
    • Cystine
    • Xanthene
    • Uric acid

Acute Kidney Injury (AKI) & Dialysis

  1. Acute kidney injury is diagnosed if:

    • Serum creatinine increases ≥ 0.3 mg/dL from previous value
    • Serum creatinine increases ≥ 50% from baseline
    • Urine output <0.5 ml/kg/hr for >6 hrs
    • All of the above

  2. RIFLE criteria is related to:

    • Acute kidney injury
    • Congestive heart failure
    • Stroke
    • Deep venous thrombosis

  3. Which drugs are nephrotoxic?

    • NSAIDs
    • Aminoglycosides
    • Radio-opaque IV contrast
    • All of the above

Diabetes & Metabolism

  1. Which of the following is NOT a function of insulin?

    • Increases glucose uptake in muscles
    • Increases lipolysis
    • Increases glycogenesis
    • Increases lipogenesis

  2. Which of the following is NOT a classical symptom of diabetes mellitus?

    • Polyuria
    • Polydipsia
    • Polyphagia
    • Polymorphism

  3. Class II obesity is defined as BMI:

    • 25-30
    • 30-40
    • 30-34.9
    • 35-39.9

  4. Common insulin injection sites include all EXCEPT:

    • Periumbilical area
    • Lateral thighs
    • Upper outer arm
    • Flank area

  5. Diabetic ketoacidosis (DKA) is more common in:

    • Gestational DM
    • Type 1 DM
    • Type 2 DM
    • Same in all

  6. Normal fasting blood sugar level is:

    • <70 mg/dL
    • <100 mg/dL
    • <110 mg/dL
    • <126 mg/dL

  7. Diagnosis of diabetes mellitus is made if:

    • HbA1c ≥ 6.5%
    • FBS ≥ 126 mg/dL
    • 2-hour postprandial glucose ≥ 200 mg/dL
    • RBS ≥ 200 mg/dL with symptoms of hyperglycemia
    • All of the above

  8. Which is the first-line pharmacological treatment for Type 2 Diabetes?

    • Metformin
    • Glimepiride
    • Acarbose
    • Insulin

  9. Common side effect of metformin:

  • GI upset
  • Headache
  • Hypotension
  • Arrhythmia

    Diabetes & Its Complications

    1. Maximum daily dose of metformin is:
    • 1000 mg
    • 1500 mg
    • 2000 mg
    • 2500 mg
    1. Which of the following is NOT true about metformin?
    • It is safe in pregnancy
    • Dose adjustment is needed in case of renal impairment
    • It causes hypoglycemia
    • Diarrhea and nausea are common symptoms
    1. Which is an acute complication of diabetes mellitus?
    • Diabetic ketoacidosis (DKA)
    • Diabetic nephropathy
    • Diabetic retinopathy
    • Diabetic neuropathy
    1. Which of the following is NOT a macrovascular complication of diabetes?
    • Coronary artery disease
    • Peripheral artery disease
    • Cerebrovascular disease
    • Diabetic retinopathy
    1. Normal 2-hour postprandial (PP) blood glucose after ingestion of 75 g of glucose is (mg/dL)?
    • <126
    • <140
    • <180
    • <200
    1. Impaired glucose tolerance is diagnosed when HbA1c is (%):
    • 4.5 – 5.5
    • 5.7 – 6.4
    • 6.5 – 7.0
    • 6.0 – 8.0
    1. Target 2-hour postprandial (PP) blood sugar in type 2 DM patients under treatment should be:
    • <120 mg/dL
    • <140 mg/dL
    • <180 mg/dL
    • <200 mg/dL
    1. Recommended level of exercise for a diabetic patient is:
    • 30 minutes twice daily
    • 60 minutes every day
    • 30 minutes, 6 days a week
    • 4-5 hours once weekly
    1. In the plate model for a diabetic diet, what portion of the plate should be covered by green vegetables and fruits?
    • One-third
    • Half
    • Two-thirds
    • Three-fourths
    1. What percentage of total calorie intake should come from carbohydrates in a diabetic patient’s diet?
    • <30%
    • <50%
    • 40-60%
    • 60-80%
    1. Eye examination should be done in diabetic patients every:
    • 3 months
    • 6 months
    • Every 5 years
    • Annually
    1. Target blood pressure for diabetic patients is:
    • <110/70 mmHg
    • <120/70 mmHg
    • <130/80 mmHg
    • <140/90 mmHg

    Endocrinology & Insulin Therapy

    1. Route of administration of insulin is:
    • Intravenous (IV)
    • Subcutaneous (SC)
    • Intramuscular (IM)
    • Both a and b
    1. Common age of onset of Type 1 Diabetes is:
    • 10-25 years
    • 25-40 years

    • 40 years

    • <10 years
    1. Diabetic ketoacidosis (DKA) is characterized by:
    • Hyperglycemia
    • Metabolic acidosis
    • Ketosis
    • All of the above
    1. Which of the following is NOT a common insulin injection site?
    • Periumbilical area
    • Lateral thighs
    • Upper outer arm
    • Flank area
    1. Which of the following is NOT a function of insulin?
    • Increase glucose uptake in muscles
    • Increase lipolysis
    • Increase glycogenesis
    • Increase lipogenesis
    1. Which of the following is NOT a classical symptom of Diabetes mellitus?
    • Polyuria
    • Polydipsia
    • Polyphagia
    • Polymorphism

    Dialysis & Kidney Failure

    1. Which of the following is NOT an indication for dialysis?
    • Persistent hyperkalemia
    • Dysnatremia
    • Severe metabolic acidosis
    • Pulmonary edema
    • Uremic encephalopathy
    1. Peritoneal dialysis is superior to hemodialysis in:
    • Easy to perform
    • No expensive equipment needed
    • Easy to perform even in neonates
    • Less expensive
    • All of the above
    1. Which of the following is NOT a cause of prerenal acute kidney injury (AKI)?
    • Hypovolemia
    • Congestive cardiac failure (CCF)
    • Diuretics
    • Bladder calculus
    1. RIFLE criteria is used for assessing:
    • Acute kidney injury
    • Congestive heart failure
    • Stroke
    • Deep venous thrombosis
    1. Which of the following drugs are nephrotoxic?
    • NSAIDs
    • Aminoglycosides
    • Radio-opaque IV contrast
    • All of the above

    Obesity & Metabolic Syndrome

    1. Class II obesity is defined as BMI:
    • 25-30
    • 30-40
    • 30-34.9
    • 35-39.9
    1. Which of the following is the first-line pharmacological management of Type 2 Diabetes?
    • Metformin
    • Glimepiride
    • Acarbose
    • Insulin
    1. Common side effect of metformin is:
    • Gastrointestinal (GI) upset
    • Headache
    • Hypotension
    • Arrhythmia
    1. Which of the following is NOT a macrovascular complication of diabetes?
    • Coronary artery disease
    • Peripheral artery disease
    • Cerebrovascular disease
    • Diabetic retinopathy
 In this page you Can see Micas based On latest syllabus provided by NHPC Nepal
for CMA and Physician assistant (Health assistant HA ). Please take your time
reading it.
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