A 35-year-old woman presents to her GP with complaints of excessive thirst and frequent urination. She is currently 20 weeks pregnant and this is her first pregnancy. Her BMI is 30 kg/m². The GP decides to conduct an oral glucose tolerance test to investigate the possibility of gestational diabetes.
What finding would confirm the suspicion of gestational diabetes in this case?
A 35-year-old woman presents to the Endocrinology Clinic with bruising, striae, acne and hirsutism.
On examination, the patient appears lethargic and depressed, with centripetal obesity and demonstrable proximal myopathy. Her blood pressure is 165/106 mmHg
Investigations reveal the following:
Investigation Result Normal values
Sodium (Na+) 136 mmol/l 135–145 mmol/l
Potassium (K+) 2.8 mmol/l 3.5–5.0 mmol/l
Random glucose 8.2 mmol/l 3.9–7.1 mmol/l
A low-dose dexamethasone test and a 24-hour urinary cortisol test are ordered.
Which of the following is the most common cause of Cushing syndrome?
A 32-year-old man is diagnosed with a phaeochromocytoma.
The urine levels of which of the following is most likely to be elevated in this patient?
A 75-year-old woman presents to the breast clinic with a painless lump in her left breast. After undergoing triple assessment, she is diagnosed with oestrogen receptor-positive breast cancer and her oncologist prescribes anastrozole as treatment. What potential risks may this medication pose for her?
A 68-year-old man is admitted for an elective total knee replacement (TKR).
His past medical history includes type 2 diabetes mellitus (T2DM), which is well controlled with metformin 500mg BD and gliclazide 80 mg OD.
The surgery is scheduled for the morning, but he is not placed on a variable rate insulin infusion (VRII).
What adjustments should be made to his antidiabetic medication regimen on the day of surgery?
A 57-year-old male patient with a history of type 2 diabetes mellitus and hypertension is admitted to a surgical ward for a routine cholecystectomy. He is currently taking metformin 500mg BD, gliclazide 120 mg BD, ramipril 5mg, and atorvastatin 20 mg. The nurse on the morning drug round asks the doctor if they should administer the morning dose of gliclazide, as the surgery is scheduled for 9 am. What should the doctor advise the nurse?
A 55-year-old woman has been diagnosed with acute cholecystitis and is set to undergo a cholecystectomy in 4 days. She is currently managing her type 1 diabetes with a daily dose of 20 units of long acting insulin in the morning. What is the appropriate once-daily dose of insulin for her to take the day before her surgery?
A 65-year-old man has scheduled an elective inguinal hernia surgery and is a diabetic taking metformin once daily. His blood glucose levels have been well controlled. He is wondering what he should do with his medication before the surgery.
What advice would be appropriate for him?
A 65-year-old man is scheduled for elective surgery to repair an umbilical hernia. He has a medical history of osteoarthritis and type two diabetes mellitus. He takes paracetamol 1 gram four times daily and metformin 500 mg once daily at breakfast. The surgery is expected to last for an hour and is scheduled for 11am. What is the appropriate management of his metformin on the day of surgery?
A 26-year-old primigravida visits her General Practitioner at 25 weeks of gestation after her midwife detected glucose in a routine urinalysis. The patient’s results are as follows:
– Blood pressure: 129/89 mmHg
– Fundal height: 25.5 cm
– Fasting plasma glucose: 6.8 mmol/L
What treatment option should be provided to this patient?