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Endo 4

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jean robert
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05/24/08 - 09:46 AM

A 35 yr old obese XX is diagnosed with severe type 2 DM with fasting blood glucose of 221 mg/dl (normal 90-110mg/dl). she complains of episodes of blurry vision and tingling in her feet. Her menstrual perios are very irregular, averaging only one about every 4 months. Her PE includes mild to moderate hirsutism, thick, darkened skin on the back of her neck, and red papillomas on her buttocks. a funduscopic examination reveals retinal damage and an angiogram indicates coronary artery disease. Her severe hyperglycemia most likely contributed to the etiology of which of the following symptoms?

a) Her acanthosis nigricans and peripheral neuropathy

b) Her acanthosis nigricans and the eruptive xanthomas on her buttocks

c) Her hirsutism and oligomenorrhea

d) Her retinal damage and blurry vision

e) The eruptive xanthomas on her buttocks and her peripheral neuropathy

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new_n_lost
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05/25/08 - 04:46 PM

d) Her retinal damage and blurry vision

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SILVER
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05/25/08 - 09:38 PM

D

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Tiff
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05/26/08 - 09:47 AM

agree with D

medikus
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05/26/08 - 02:52 PM

Can anyone explain to me why is not peripheral neuropathy? Does retilanl damage comes first? Thanks

hitesh
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05/26/08 - 11:29 PM

D

Medikus: peripheral neuropathy is becuase of hyperglycemia. But option 'a' also has acanthosis nigricans( which is not becuase of hyperglycemia) and thus makes 'd' the best answer.

Acanthosis nigricans is becuse of hyperinsulinemia. The elevated insulin levels in the body activate insulin receptors in the skin, forcing it to grow abnormally

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new_n_lost
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05/27/08 - 09:27 AM

hitesh wrote:
D

Medikus: peripheral neuropathy is becuase of hyperglycemia. But option 'a' also has acanthosis nigricans( which is not becuase of hyperglycemia) and thus makes 'd' the best answer.

Acanthosis nigricans is becuse of hyperinsulinemia. The elevated insulin levels in the body activate insulin receptors in the skin, forcing it to grow abnormally

The basic factor driving the hyperinsulinemia is the Insulin resistence which is mostly seen in Obese patients.

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"never argue with a fool, they'll bring you down to their level and beat you with experience" 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."

medikus
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05/27/08 - 12:39 PM

hitesh, thank so much for explanation. Does make sence to me.

sigh
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05/28/08 - 05:41 AM

I go with A because I want to be special grin