High-yield diabetes for the USMLE Step 2 CK exam – Part 1

by / Friday, 04 June 2010 / Published in Uncategorized

Diabetes is a very high-yield topic for the USMLE Step 2 CK exam.  Actually, it is so important that you are likely to get at least 15-20 questions on the CK exam about diabetes alone (I did).  And come step 3, you will probably have close to the same, if not more.  Take the time to thoroughly study and understandeverything there is to know about diabetes and you can get an easy 15-20 points on the CK exam.  

This is Part 1 of a 5 part series about diabetes, so be on the lookout for the rest coming within the next couple days.

Here is Part 1 of the super high-yield diabetes series.

Hypertension – Control is essential in DM patients because it causes long-term complications of the heart, eye, kidney, and brain.  Goal is to keep it <130/90

Lipid Management – Goals are: LDL <100, if patient has CAD + DM, the goal is <70. 

Retinopathy – Diabetics require a yearly eye exam to detect proliferative retinopathies.  If present, laser coagulation should be performed.

Nephropathy – If any form of protein is present in the urine give the DM pt ACEI’s.  These prevent nephropathies and ACEI’s are 1st line drugs in DM with HTN

Neuropathy – Yearly foot exams are important.  If neuropathy is present there is no need to delay treatment with gabapentin or pregabalin.

Erectile Dysfunction – Ask patient about this, sildenafil or tadalafil work well but do not give if they are also on nitrates

Gastroparesis – More common in long-term diabetics, there is impaired stretch-receptors and thus impaired motility.  Patient will have bloating, constipation, fullness, and diarrhea.  Give metoclopramide or erythromycin (increase gastric motility)

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