A 16-year-old boy is evaluated for excessive urination and increased thirst. The patient's mother has type 2 diabetes. On examination, vital signs are normal. BMI is 35. Results of general physical and neurological examinations are unremarkable. He is not dehydrated. His investigations show HbA1c 8.7%, random glucose 324 mg/dl, normal electrolytes, and negative urine ketones Which of the following diagnostic studies is most likely to identify the cause of this patient's diabetes?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Obtain islet cell and glutamic acid decarboxylase antibodies
In an obese teenager, the key question is whether the diabetes is autoimmune (type 1) or type 2. Positive anti-GAD / islet-cell antibodies identify autoimmune type 1 DM, so they show the cause. C-peptide and insulin levels only estimate how much insulin is being secreted.
ليش كل خيار صح أو غلط
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A
ليش غلط
A C-peptide level, even stimulated, only shows how much insulin the beta cells make (high suggests type 2, low type 1); the antibodies are what point to an autoimmune cause.
✓ 11• Diabetes Mellitus [Notes].pdf · p. 8 -
B
ليش غلط
Endogenous insulin is low in type 1 but can be normal, decreased or increased in type 2, so a fasting insulin level does not separate the two.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 2 -
C
ليش غلط
Fasting C-peptide is made with insulin by the beta cells: high suggests type 2 (early/mid stage), low suggests type 1. It estimates secretion rather than showing the autoimmune cause.
✓ 11• Diabetes Mellitus [Notes].pdf · p. 8 -
D
ليش صح
Positive anti-GAD and anti-islet antibodies suggest type 1 DM, so they identify an autoimmune cause in an obese teenager.
✓ 11• Diabetes Mellitus [Notes].pdf · p. 8
- المصدر
- 11• Diabetes Mellitus [Notes].pdf · p. 8
- المحاضرة
- Diabetes Mellitus · Endocrinology · Module B
- ظهر في
- Endo bank