Pathology EMQ template.

Name: Alexandra Ho

Theme: Hypoglycaemia

 

OPTION LIST

 

A	Alpha-Glucosidase inhibitor	I	Respiratory Acidosis
B	Biguanide	J	Respiratory Alkalosis
C	Chlorpropamide	K	Sulfonylurea
D	Impaired Fasting Glucose	L	Thiazolidinedione
E	Impaired Glucose Tolerance	M	Type 1 DM + Diabetic ketoacidosis
F	Metabolic Acidosis	N	Type 1 DM + Hyperosmolar non-ketotic coma
G	Metabolic Alkalosis	O	Type 2 DM + Diabetic ketoacidosis
H	Prandial glucose regulator	P	Type 2 DM + Hyperosmolar non-ketotic coma

 

 

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

 

1. A 75-year old lady with Type 2 DM who previously presented with hyperglycaemia in A&E, has now been found at home confused, sweating, and a heartrate of 110bpm. What is the likely cause for her symptoms?*

 

2. A 27-year old man presents with a 3 week history of flu-like illness, with increasing thirst and urinary frequency. This morning he experienced nausea, vomiting and abdominal pain; he is now shaking, sweating and confused. His wife says his breath smells funny. What is the likely diagnosis, and this presenting complication?

 

 

3. The same patient’s breathing is deep and laboured. This suggests…?

 

 

 

4. A 55-year old Asian man presents to your clinic with polydipsia and polyuria. His fasting glucose is 6.0mmol/l. 2 hours after 75g glucose during an OGTT his plasma glucose is 9.1mmol/l. This patient has…?

 

 

5. 4 weeks later the same patient returns to you complaining of constant feelings of bloatedness and flatulence. He also dislikes that he has gained weight despite trying to follow your advice to lose it. The cause of these symptoms is…?

 

 

 

ANSWERS

1. C

2. M

3. F

4. E

5. A

 

 

(*A sulphonylurea that may be contraindicated in the elderly due to its long half-life which may cause a cumulative dose effect of hypoglycaemia between consecutive doses.)