A 60-year-old man known to have type 2 diabetes comes for regular follow up. He is on metformin 2 g per day and gliclazide 160 mg per day. His recent HbA1c was 8.4% and his blood pressure was 140/75 mmHg. Eye examination reveals dot and blot haemorrhages and microaneurysms. None are close to the macula. Which of the following defines his eye condition?
A 30-year-old man with type-1 diabetes mellitus on insulin presents in the A&E with fever, cough, vomiting and abdominal pain. Examination reveals a dry mucosa, decreased skin turgor and a temperature of 37.8 °C. Chest examination reveals bronchial breathing in the right lower lobe, and a chest X-ray shows it to be due to a right lower zone consolidation. Other investigations show: Blood glucose: 35 mmol/L, Na+: 132 mmol/L, K+: 5.5 mmol/L, urea: 8.0 mmol/L, creatinine: 120 μmol/L, pH: 7.15, HCO3: 12 mmol/L, p(CO2): 4.6 kPa, chloride: 106 mmol/l. Urinary ketones are positive (+++). The patient is admitted to the hospital and treated. Which of the following should not be used while treating him?
All of the following are true regarding the management of thyroid diseases during pregnancy, except?
A 15-year-old girl presents with vomiting and her investigations show: Sodium 115 mmol/L (137-144), Potassium 3.0 mmol/L (3.5-4.9), Urea 2.1 mmol/L (2.5-7.5), Urine sodium 2 mmol/L, Urine osmolality 750 mosmol/kg (350-1000). What is the most likely diagnosis?
A 15-year-old child with learning difficulties is referred to the endocrine clinic for review. His lab results show hypocalcaemia and increased serum concentration of parathyroid hormone. On examination, there is subcutaneous calcification and a short fifth metacarpal in each hand. What is the treatment of choice in this case?
A 25-year-old woman comes to the endocrine clinic for her regular follow up. She has hypertension, controlled by a combination of Ramipril and indapamide and was diagnosed with 11-beta hydroxylase deficiency since birth when she was found to have clitoromegaly. Which of the following is most likely to be elevated?
A 40-year-old man presents with recurrent headaches, 2-3 times a day, associated with sweating and palpitations. His blood pressure during the attacks is around 220/120 mmHg. Given the likely diagnosis, what is the next appropriate investigation?
A 27-year-old woman presents with recurrent headaches and sweating. On examination, a nodule is felt in the region of the thyroid gland. She mentions that her mother had kidney stones and died following a tumour in her neck. A surgeon recommends complete thyroidectomy as her treatment of choice. What is the most important investigation to be done before the surgery?
A 23-year-old man who works as a clerk presents for review. He is 6 feet 2 inches tall, with delayed puberty and infertility. On examination, he has small testes with scanty pubic hair. Blood results are shown below: Follicle-stimulating hormone (FSH) 40 U/l (1–7), Testosterone 4 nmol/l(9–35). What is the most probable diagnosis?
A 60-year-old Muslim man with type 2 diabetes comes to the clinic for advice. He is about to start fasting for Ramadan and he is not sure how to modify the administration of his diabetes medications. He is currently on metformin 500mg tds. What is the most appropriate advice?