Pathology EMQ template.

Name: Sonal Halai

Candidate number:

Theme: Hypoglycaemia

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  

OPTION LIST

 

A	Von Gierke’s Disease	I	Cushing’s syndrome
B	Insulinoma	J	Addison’s Disease
C	Type I Diabetes Mellitus	K	Excessive Alcohol
D	Type II Diabetes Mellitus	L	Septicaemia
E	Quinine Therapy	M	Reye’s Syndrome
F	Post Gastrectomy	N	Insulin Overdose
G	Non-Islet Cell tumour Hypoglycaemia	O
H	Hypopituitarism	P

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 55 year old female is admitted with a history of sweating, blurred vision, palpitations and confusion following exercise. The blood glucose level is 3.2 mmol/L and the insulin level is not suppressed during a supervised prolonged fast.

 

2. A 68 year old with a past medical history of malaria presents with confusion, sweating and seizures. The blood glucose level is

3.0 mmol/L.

 

3. An 8 month old child is brought into A&E unconscious with a past medical history of seizures. On examination the child has marked hepatomegaly. Investigations reveal raised FFA, raised 3-hydroxy-butyrate and metabolic acidosis.

 

 

4. A 47 year old male with a PMH of cancer which was treated with surgery presents unconscious to A&E. Clinical investigation reveals blood glucose level of 1.2 mmol/L and markedly elevated levels of big IGF-II.

 

5. A 19 year old male is brought into A&E unconscious following a night out to celebrate the end of exams. Blood tests reveal a plasma glucose level of 1.8 mmol/L and a metabolic acidosis.

 

 

 

ANSWERS

1. B

2. E

3. A

4. G

5. K