A 56-year-old man is evaluated after being diagnosed with hypertension. As part of his assessment, he underwent a series of blood tests to screen for other risk factors:
Na+ 142 mmol/l
K+ 3.9 mmol/l
Urea 6.2 mmol/l
Creatinine 91 µmol/l
Fasting glucose 7.7 mmol/l
Total cholesterol 7.2 mmol/l
Due to the fasting glucose result, you order a HbA1c:
HbA1c 31 mmol/mol (5.0%)
What could account for the discrepancy between the HbA1c and fasting glucose levels?
A 63-year-old man comes to the clinic complaining of breast tissue enlargement. He is feeling very self-conscious and anxious about his upcoming summer vacation. Which medication is the most probable cause of his condition?
A 68-year-old woman presents to the emergency department with acute confusion. She arrives unaccompanied and is unable to provide any information about her medical history. Upon examination, she appears overweight and has non-pitting edema in her eyes and legs. Additionally, she has dry skin and coarse hair. Her vital signs include a heart rate of 50 beats/min, blood pressure of 90/60 mmHg, respiratory rate of 10 breaths/min, temperature of 30°C, and oxygen saturation of 90% on air. What is the most probable diagnosis?
As you review the blood results of a 65-year-old man who has been diagnosed with hypertension, you notice that a HbA1c level was requested as part of the routine work-up. What HbA1c range would be indicative of prediabetes?
A 79-year-old man with a medical history of prostate cancer, asthma, and COPD presents to the emergency department with complaints of abdominal pain, bone pain, and general weakness. During investigations, a shortened QT interval is noted on his ECG. What is the initial management approach for this complication in this patient?
A 54-year-old man is seen in the Cardiology clinic after experiencing a heart attack a year ago. He was diagnosed with hypertension and diabetes during his hospitalization. The patient reports gaining 5kg in the last 6 months and wonders if any of his medications could be causing this weight gain. Which of his prescribed drugs may be contributing to his recent weight gain?
What is the most probable adverse effect experienced by patients who are taking gliclazide?
A 45-year-old woman presents to her general practitioner with a complaint of feeling tired and lethargic for the past six months. She also reports a weight gain of approximately 10 kg during this time. Upon conducting a blood test, the following results were obtained: Hb 141 g/l, Na+ 141 mmol/l, Bilirubin 7 µmol/l, Platelets 331 * 109/l, K+ 4.1 mmol/l, ALP 71 u/l, WBC 4.6 * 109/l, Urea 3.9 mmol/l, ALT 31 u/l, Neuts 3.1 * 109/l, Creatinine 86 µmol/l, γGT 51 u/l, Lymphs 1.2 * 109/l, TSH 0.1 mu/l, Albumin 41 g/l, Eosin 0.2 * 109/l, free-T4 3 nmol/l, and CRP 4.1 mg/l. What would be the most appropriate next investigation to determine the cause of her fatigue?
A 45-year-old man has been referred by his GP due to a history of uncontrolled hypertension. He has come in today to undergo an aldosterone: renin ratio test. The results indicate high levels of aldosterone and low levels of renin. Additionally, a CT scan has revealed bilateral adrenal gland hyperplasia.
What is the recommended management plan for this patient?
A 42-year-old man is being evaluated for possible diabetes mellitus and undergoes an oral glucose tolerance test using the standard WHO protocol. The results are as follows:
Time (hours) Blood glucose (mmol/l)
0 5.9
2 8.2
What is the interpretation of these findings?