BANK OF CLINICAL CASES BY ENDOCRINOLOGY FOR MODULE 1

Case N 1. Child, 11 years old presents with recidivating of furunculouses. Fasting blood glucose is 7,9 mmol/1, glucose and acetone absent in urine. What is the most likely diagnosis?

1. Type 1diabetes mellitus

2. Chronic infections

3. Type 2 diabetes mellitus

4. Dermatopathi

5. Diabetic ketoacidosis

Case N 2. Patient V., 26 years old, complains of an itch about the genitals, frequent urination, tiresome thirst, weight gain. These symptoms were evidenced over several months. Fasting blood glucose - 12,0 mmol/1, glucose in urine - 1,5 %. What is the most likely diagnosis?

1. Type 1diabetes mellitus

2. Diabetes insipidus

3. Type 2 diabetes mellitus

4. Dermatopathi

5. Chronic infections

Case N 3. Patient with persistent dermatomyositis examined glucose and appearance such results: the fasting level – 5,55 mmol/L and 6,68 mmol/L, during the day 7,85 - 9,11 -11,13 mmol/L. Your conclusion:

1. Impairment of carbohydrate tolerance

2. Normal

3. Diabetes mellitus

4. Necessary to order additional laboratory tests.

5. Needed an add examination

Case N 4. Patient M., 27 years, after recovering from the flu, complaining of thirst, frequent urination, and weight loss. Blood glucose is - 12,3 mmol/L, glucose in urine - 3%, acetone - +. What is your previous diagnosis?

1. Diabetes insipidus

2. Type 2 diabetes mellitus

3. Type 1diabetes mellitus, adequate control

4. Type 1diabetes mellitus, inadequate control, ketosis

5. Type 2 diabetes mellitus, inadequate control, ketoacidosis

Case N 5. Which of the statement given below is correct relatively to glucose-tolerance test (GTT)?

1. Helpful to choose the most appropriate treatment

2. Used to differentiate type of diabetes

3. Indicate stage of diabetes

4. Useful in the seeking of early diabetic complications

5. Correlates with determination of potential abnormalities of glucose tolerance

Case N 6. Interpret glucose -tolerance test (GTT). Glycemia: I trial – 5,3 mmol/L, II trial – 7,8 mmol/L, III trial – 4,8 mmol/L:

1. Normal

2. Impairment of carbohydrate tolerance

3. Diabetes mellitus

4. Necessary to order additional laboratory tests.

5. Additional laboratory investigations are indicated

Case N 7. A patient F., 30 year old woman who has had Type 1 diabetes for 10 years calls the clinic because she has had profuse watery diarrhea and nausea for 8 hours but without emesis. Her 12-year-old daughter had similar symptoms when she had viral gastroenteritis 2 days earlier. The patient has followed her sick-day rules and is drinking diet ginger ale alternating with regular ginger ale for hydration, but she is only able to take sips, and this is becoming increasingly difficult. Her blood glucose level is 14,21 mmol/L and urinary ketones are moderate. She reports a dry mouth and dizziness on standing. Her usual insulin regimen is a basal-bolus therapy with insulin detemir twice daily and insulin lispro at meals. Which of the following is the most appropriate next step for this patient to take?

A.  Go to the emergency department for intravenous hydration

B.  Continue to follow sick-day rules and call again if urinary ketones are large

Начало формы

Конец формы

C.  Increase rapid-acting insulin by 20% of the total daily dose

Начало формы

Конец формы

D.  Stop taking any insulin until the ability to eat returns

Case N 8. The girl of 12 years fell ill of diabetes mellitus after respiratory infec­tion. She was treated by short-acting insulin in four injections. After 2 weeks after the beginning of treatment hypoglycemias have begun. The dose of the insulin decreased gradually to complete cancellation. Now the girl has normoglycemia and glucose in urine - normal. Such state is connected with: