Pathology EMQ template.

Name: Koh, Don

Theme: Hypoglycaemia

OPTION LIST

A	Alcohol abuse	I	Islet Cell Hyperplasia
B	Anorexia nervosa	J	Paraneoplastic syndrome
C	Drug-induced hypoglycaemia	K	Prolactinoma
D	Gastric dumping syndrome	L	Sulphonylurea
E	Gastrinoma	M	Type I diabetes
F	Hyoglycaemic unawareness	N	Type II diabetes
G	Insulin overdose	O
H	Insulinoma	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. 29 year old patient presents with feeling faint, tremors and palpitations. Blood glucose <4mmol/L. Laboratory results shows that both insulin and C-peptide levels are raised. Previously fit and well. Father previously had a thyroidectomy.

2. Hypoglycaemia with low glucose, C-peptide and insulin. No trace ketones and free fatty acids were detected. This did not change despite glucose administration.  

3. Patient with a BMI >40 kg/m^2 but with no history of diabetes collapses in the surgical ward while going to the toilet post-dinner.

4. Newly born, macrosomic baby shows signs of irritability and failure to thrive. Blood sugar levels were 2.6 mmol/L. This was reversed upon normal feeding.

5. HIV patient in the respiratory ward, with non-productive cough and shortness of breath. Patient appears cachectic and has a fever. Blood glucose levels were closely monitored.

ANSWERS

1. C

2. G

3. N

4. D

5. K