DM Clinical Case Flashcards
Clinical Case Question
Answer
A 45-year-old woman presents with excessive thirst, frequent urination, and unexplained weight loss. Her fasting blood glucose is 140 mg/dL. What is the likely diagnosis?
Type 2 diabetes mellitus.
A 12-year-old boy presents with polyuria, polydipsia, and fatigue. His fasting glucose is 280 mg/dL, and ketones are present in urine. What is the most likely diagnosis?
Type 1 diabetes mellitus.
A 55-year-old man with poorly controlled diabetes presents with foot pain, ulceration, and peripheral neuropathy. What is the likely diagnosis?
Diabetic foot ulcer due to neuropathy and peripheral arterial disease.
A 35-year-old woman presents with fasting glucose of 130 mg/dL and an HbA1c of 6.7%. What is the appropriate diagnosis?
Diabetes mellitus.
A 60-year-old man with a history of Type 2 diabetes presents with confusion, dehydration, and a blood glucose of 600 mg/dL without ketonemia. What is the likely diagnosis?
Hyperosmolar Hyperglycemic State (HHS).
A 25-year-old woman presents with nausea, vomiting, deep labored breathing (Kussmaul respirations), and a blood glucose of 450 mg/dL. What is the likely diagnosis?
Diabetic ketoacidosis (DKA).
A 50-year-old man with diabetes has recurrent episodes of hypoglycemia despite regular meals. What medication is most likely responsible?
Sulfonylureas (e.g., glipizide, glyburide).
A 40-year-old man with obesity and a family history of diabetes has an HbA1c of 6.2%. What is the diagnosis?
Prediabetes.
A 28-year-old pregnant woman is diagnosed with gestational diabetes. What is the preferred initial treatment?
Dietary modification and exercise; insulin if needed.
A 55-year-old woman with diabetes presents with vision changes. Fundoscopy reveals retinal hemorrhages and neovascularization. What is the likely diagnosis?
Diabetic retinopathy.
A 48-year-old man with Type 2 diabetes has persistent proteinuria and a declining eGFR. What is the most appropriate treatment to prevent progression?
ACE inhibitors or ARBs.
A 65-year-old man with diabetes and hypertension presents with sudden chest pain and diaphoresis. What complication should be suspected?
Myocardial infarction.
A 72-year-old woman with diabetes and chronic kidney disease is started on metformin. What is the primary concern?
Lactic acidosis.
A 30-year-old woman with recurrent yeast infections, fatigue, and an HbA1c of 7.8% is diagnosed with Type 2 diabetes. What class of medication should be avoided?
SGLT2 inhibitors (due to increased risk of genital infections).
A 45-year-old man with diabetes and a BMI of 35 is started on liraglutide. What is the benefit of this medication?
Weight loss and improved glucose control.
A 55-year-old man with Type 2 diabetes presents with painful burning sensation in both feet. What is the most likely cause?
Diabetic neuropathy.
A 60-year-old man with diabetes has an HbA1c of 9.5% despite metformin. What is the next step in management?
Add a second agent, such as a GLP-1 receptor agonist or SGLT2 inhibitor.
A 35-year-old woman with diabetes presents with recurrent urinary tract infections. What diabetes medication might be contributing?
SGLT2 inhibitors (e.g., empagliflozin).
A 50-year-old man with diabetes and hypertension presents with intermittent claudication. What is the likely diagnosis?
Peripheral arterial disease.
A 42-year-old woman with long-standing diabetes presents with early morning hyperglycemia. Her nighttime glucose is low. What is the most likely cause?
Somogyi effect (rebound hyperglycemia after nocturnal hypoglycemia).
A 60-year-old woman with diabetes has an HbA1c of 10% and presents with weight loss and fatigue. What should be suspected?
LADA (Latent Autoimmune Diabetes in Adults).
A 70-year-old woman with diabetes presents with progressive numbness in her hands and feet. What test should be performed?
Monofilament test for diabetic neuropathy.
A 40-year-old man with poorly controlled diabetes presents with a non-healing foot ulcer. What is the next step?
Wound care, infection control, and vascular assessment.
