CME questions: improving antihypertensive therapy in patients with diabetic nephropathy.

1. The most common cause of end-stage renal disease in the USA is:

a. Polycystic kidney disease 

b. Glomerulonephritis 

c. Diabetes

d. Hypertension

2. The 5-year survival rate on dialysis is approximately:

a. 70%

b. 50%

c. 30%

d. 20%

3. The rate of progression of chronic renal disease in diabetes is most affectively reduced by:

a. Reducing LDL 

b. Aspirin therapy

c. Control of Alc Hgb below 6.5%

d. Blood pressure goal of less than 130/80

4. The percentage of diabetics developing diabetic nephropathy is about:

a. 10-20%

b. 20-30%

c. 30-40%

d. 40-50%

5. The incidence of hypertension in diabetes is about:

a. 30%

b. 50%

c. 60%

d. 80%

6. The clinical goal for hypertensive diabetics according to guidelines (JNC 7, ADA, NKF) is below:

a. 130/80

b. 120/80

c. 140/85

d. 135/85

7. The strongest predictor for end-stage renal disease development in all diabetics is:

a. Alc Hgb > 8.0

b. LDL levels above 160

c. Hypertension

d. Albuminuria 

8. Which antihypertensive class should be the cornerstone for hypertensive diabetics:

a. Beta blockers

b. Non-dihydropyridine calcium antagonists

c. Diuretics

d. RAS blockers (ACE inhibitors/angiotensin receptor blockers)

9. Which creatinine level needs diuretic therapy with thiazides changed to loop diuretics (or metolazone)

a. Creatinine above 1.2 mg

b. Creatinine above 1.4 mg

c. Creatinine above 1.7 mg

d. Never

10. The treatment of diabetic nephropathy includes:

a. Control of hypertension below 130/80

b. Reduction of albuminuria to lowest achievable level

c. Prescribing of a RAS-blocker (ACE/ARB)

d. All of the above

Answers to CME Questions

1. C, 2. C, 3. D, 4. B, 5. D, 6. A, 7. D, 8. D, 9. C, 10. D