KMU Past Paper Practice

A 52-year-old asymptomatic man undergoes routine health assessment. His HbA1c is 6.7%, with no previous evidence of hyperglycaemia. Which approach is most appropriate before establishing the diagnosis?

A 44-year-old woman with a strong family history of diabetes undergoes a 75-g oral glucose tolerance test. Her fasting plasma glucose is 112 mg/dL and the 2-hour value is 208 mg/dL. How should the result be interpreted?

A pregnant woman with no known pre-existing diabetes is found to have hyperglycaemia during pregnancy. The abnormalities do not indicate clearly established diabetes before pregnancy. Which category best describes her condition?

A 46-year-old man with marked visceral obesity has elevated fasting insulin but only mildly raised blood glucose. Which metabolic change most directly links excess adipose tissue with impaired insulin action?

A patient with long-standing diabetes develops symmetrical numbness and reduced vibration sense in both feet. Which pathological process best explains this complication?

A 59-year-old man with diabetes, hypertension and dyslipidaemia develops an acute myocardial infarction. Which process most strongly links diabetes with this macrovascular complication?

A patient using subcutaneous insulin notices a painless thickened fatty swelling at a frequently used injection site. Glucose control has also become less predictable. Which behaviour most likely caused this problem?

NPH insulin provides a longer duration of action than regular insulin after subcutaneous injection. Which pharmacokinetic feature is primarily responsible?

A patient requires sustained basal insulin coverage with minimal rapid peaks. Which property of long-acting insulin analogues best produces this clinical profile?

After insulin binds to its receptor on skeletal muscle, which intracellular response most directly facilitates increased glucose uptake?

A patient receiving insulin becomes unconscious from severe hypoglycaemia and cannot safely take oral carbohydrate. Glucagon is administered as rescue therapy. Which effect explains its usefulness?

A clinician classifies glucose-lowering therapy according to its principal physiological target. Which drug class lowers plasma glucose mainly by increasing urinary glucose excretion?

During a pharmacology discussion, students are asked to identify two glucose-lowering agents classified as euglycaemic because they have little tendency to cause hypoglycaemia when used alone. Which pair is most appropriate?

A patient receiving mealtime insulin is started on pramlintide to improve postprandial control. Which adverse-effect pattern should be anticipated during treatment?

A patient with type 2 diabetes requires an oral incretin-based drug that is generally weight neutral and has a low risk of hypoglycaemia when used alone. Which agent best fits these requirements?

A 20-year-old man is diagnosed with type 1 diabetes after presenting with weight loss, polyuria and marked hyperglycaemia. He is clinically stable after initial assessment. Which pharmacological principle is essential for his long-term treatment?

A community physician is identifying adults who should receive closer assessment for future type 2 diabetes risk. Which factor represents an important non-modifiable or historical risk marker?

A low-cost community programme proposes urine glucose testing as the sole screening test for diabetes. Which limitation makes this approach unsuitable for reliable diagnosis?

Two population surveys conducted in Pakistan report different estimates for the prevalence of diabetes. Both are methodologically reasonable. Which factor can most appropriately explain the difference without assuming that either study is incorrect?

A 41-year-old woman with central obesity, acanthosis nigricans, hypertension and dyslipidaemia has marked insulin resistance. Which management approach best addresses the overall syndrome rather than glucose alone?