new_n_lost
Politically InCorrect
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This May Look like A Clinical Question n U will Say this is Not a MLE question But IT IS n its also Easy ( If u know Wht i mean  )
A 33 year old nurse is admitted for prolonged fasting. She originally presented to clinic with a history of episodic sweating and light-headedness which had developed over a six month period with symptoms being entirely relieved by eating. She had developed one of these episodes whilst on the ward and a RBS monitor showed a value of 2 mmol/l. She took some glucose tablets and had quickly recovered.
On examination no specific abnormalities were found with a blood pressure of 118/74 mmHg, a pulse of 72 beats per minute and a BMI of 22 kg/m2.
She was admitted for a 72 hour fast and at 3 am, 16 hours into the fast she develops typical symptoms. Her Blood Glucose is measured at 2.2 mmol/l, the fast is stopped and bloods taken.
The following reveal her results:
Plasma Glucose 1.8 mmol/l (3 - 6)
Plasma 3 Beta-HydroxyButyrate 0.5 mmol/l (greater than 1 mmol/l)
Plasma Insulin 450 pmol/l (less than 21)
C-peptide 0.2 nmol/l (less than 0.5)
What is the most likely diagnosis?
1) Adult Glycogen storage disease
2) Factitious hypoglycemia due to Insulin treatment
3) Factitious hypoglycemia due to Sulphonylurea treatment
4) Insulinoma
5) Non-islet cell tumour hypoglycemia
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| me007
Forum Guru
Topics: 72
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2.
difference c-peptide - insulin, insulin is exogenous.
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| keepgoing
Forum Guru
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2?
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| new_n_lost
Politically InCorrect
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Lol This Forum Is going Hot Today its Morning Here in US n LAte Night in Asia n still ppl r rocking this Place.
One More Thing I forgot to Mention PLZ EXPLAIN UR ANSWERS (Me007 Exempted)
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| mytime
Kick my butt!
Topics: 39
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2 same as above
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| new_n_lost
Politically InCorrect
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Posts: 6,086
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
Politically InCorrect
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Posts: 6,086
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Choice A doesnt Fit the Clinical Picture
Choice C will have a Slightly Elevated C peptide levels but Not Insulin Levels
Choice D will have both Levels Elevated i.e Insulin N C-peptide.
Choice E is refered to the IGF -1 excess producing Tumors.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| Luckyall
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| keepgoing
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