Name: Jenny Eades

Theme: Diabetes Cases

OPTION LIST

A	Fasting plasma glucose 4.9mmol. 2hrs post OGTT plasma glucose 11.5mmol.	H	Plasma glucose 1.45mmol, pH 7.58, pCO2 2.4kPa.
B	Fasting plasma glucose 6.9mmol. 2hrs post OGTT plasma glucose 10.5mmol.	I	Plasma glucose 1.45mmol, pH 7.58, pCO2 8.1kPa.
C	Fasting plasma glucose 6.9mmol. 2hrs post OGTT whole blood glucose 10.5mmol.	J	Plasma osmolarity 285mOsmo/kg, anion gap 19mM. Glucose normal.
D	Fasting plasma glucose 7.9mmol. 2hrs post OGTT glucose 11.1mmol.
E	Fasting whole blood glucose 6.0mmol. Osmolarity 352mOsm/kg. Polyuria and polydipsia.
F	Plasma glucose 1.0mmol, pH 7.58, pCO2 2.4kPa.
G	Plasma glucose 1.4 mmol, pH 7.2, pCO2 3.0kPa. Urine positive for ketones.

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 65 year old man reports feeling lethargic and is found to have ‘impaired glucose tolerance’ by his GP.

2. A 27 year old woman is brought into A + E unconscious. Her friend says she’s had a condition all her life to do with her blood sugar, but can’t remember what it’s called. She says that her friend vomited several times before passing out.

3. An obese 40 year old woman is found on a routine blood test to have ‘impaired fasting glucose’

4. A 14 year old type I diabetic attends clinic for a routine appointment. His daily record shows well managed blood glucose levels and he complains of no other problems.

5. A 24 year old with type I diabetes is admitted to A + E with shortness of breath and a respiratory rate of 35. He is also drowsy.

ANSWERS

1. B

2. G

3. E

4. J

5. H