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PRACTICE EXAM
Why is C-peptide low with exogenous insulin?
Injected insulin does not contain C-peptide.
↑ Insulin
↑ C-peptide
↑ Proinsulin
Negative sulfonylurea screen
insulinoma
,Why is proinsulin elevated in insulinoma?
Tumor secretes endogenous insulin and incompletely processed proinsulin.
↑ Insulin
↑ C-peptide
↑ Proinsulin
Positive sulfonylurea screen (+ Secreatagon Screen)
Sulfonylurea-induced hypoglycemia
First-line treatment for a conscious patient with hypoglycemia?
Oral glucose
Which test differentiates insulinoma from surreptitious insulin use?
C-peptide (C-pep present in natural insulin)
Pork consumption → diarrhea. Most likely organism?
,Yersinia enterocolitica.
Undercooked shellfish causing diarrhea. Organism?
Vibrio
Raw oysters + liver disease causing severe sepsis. Organism?
Vibrio vulnificus.
Profuse rice-water diarrhea in a developing country. Diagnosis?
Vibrio cholerae.
First-line treatment for cholera?
Aggressive oral/IV rehydration.
drug treatments for vibrio sp.
tetracyclines (doxy)
, Bloody diarrhea after ingestion of only a few organisms. Organism?
Shigella.
Complication of Shigella tested on NBME?
Hemolytic uremic syndrome (less common than with EHEC).
Bloody diarrhea after eggs or poultry. Organism?
Salmonella.
Watery diarrhea beginning about 2 hours after potato salad. Organism?
Staphylococcus aureus.
Why is symptom onset so rapid with Staph food poisoning?
Preformed enterotoxin.