Pathology EMQ template.

Name: Alan Jumaily

Candidate number:

Theme: Hypoglycaemia

OPTION LIST

A	Addison’s disease	I	Insulinoma
B	Adverse drug reaction	J	Somatostatinoma
C	Congenital hyperinsulinism	K	T1DM
D	Conn’s syndrome	L	T2DM
E	Cushing’s disease	M	Von Gierke’s disease
F	Cushing’s syndrome	N
G	Gliclazide overdose	O
H	Glucagonoma	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 20 year old medical student presents to A&E unconscious. His friends provide a recent history of polyuria and polydipsia in addition to nausea and vomiting.

2. A 55 year old housewife presents to her GP with muscle weakness and dizziness on standing. She also notes that she still has a tan from her holiday 2 years previously. Investigation reveals hyponatraemia and hyperkalaemia.

3. A 40 year old patient presents with sweating, tremors, hunger and tachycardia when fasting or following exercise. Plasma glucose is measured as 2.3mmol/L and a prolonged supervised fast fails to suppress insulin levels.

4. A 45 year old bus driver has recently been diagnosed with type 2 diabetes mellitus. He presents to A&E unconscious with a blood glucose of 1.2mmol/L.

5. A 1 year old is taken to A&E unconscious. Clinical investigation reveals hypoglycaemia, metabolic acidosis, marked hepatomegaly and glucose-6-phosphatase deficiency.

ANSWERS

1. K

2. A

3. I

4. G

5. M