Patient with signs and symptoms of hypoglycemia, on attack he has high insulin, decrease C-peptide, what is the most likely cause?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Exogenous insulin use (factitious)
High insulin with low C-peptide = exogenous (factitious) insulin. Commercial insulin contains no C-peptide, and the injected insulin suppresses the patient's own β-cells, so C-peptide falls.
- Insulinoma and sulfonylurea misuse cause endogenous hyperinsulinism, so C-peptide is high in both (sulfonylurea is identified by a drug screen).
ليش كل خيار صح أو غلط
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A
ليش غلط
Beta cells release C-peptide together with insulin when proinsulin is cleaved, so an insulinoma gives high C-peptide, not low.
✓ DM summary.pdf · p. 1 -
B
ليش صح
If insulin is taken secretly there is a high insulin level and a low C-peptide, because exogenous insulin does not contain C-peptide.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 22 -
C
ليش غلط
Sulfonylurea misuse stimulates the patient's own insulin; it is identified by checking urine or serum for the drug, not by a low C-peptide.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 22 -
D
ليش غلط
Cortisol insufficiency is a cause of hypoglycaemia, but then insulin should be suppressed: as glucose falls, insulin levels normally decrease.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 22 -
E
ليش غلط
Reactive hypoglycaemia occurs 2 to 4 hours after a meal and rarely signals a serious disorder; the stem gives no meal link, and high insulin with low C-peptide points to injected insulin.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 22
- المصدر
- Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 22
Diabetes mellitus overall Copy.pdf · p. 6 - المحاضرة
- Hypoglycaemia · Endocrinology · Module B
- ظهر في
- Endo bank