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Results for “insulin

48 questions found

A 19-year-old woman with type 1 diabetes is on the surgical ward the evening after an appendicectomy. Two hours after her usual insulin she becomes sweaty and t…

Acute Care · Clinical rotations · middle twist

A 63-year-old woman with type 2 diabetes presents with two days of vomiting and upper abdominal pain, during which she has eaten almost nothing. She takes metfo…

Acute Care · Clinical rotations · middle twist

A 46-year-old man who drinks a bottle of spirits most days has vomited for three days and eaten nothing; he stopped drinking two days ago. He is alert, with epi…

Acute Care · Clinical rotations · niche

A 76-year-old man taking ramipril and spironolactone attends with three days of vomiting and increasing lethargy. He is drowsy but rousable. Pulse is 42/min and…

Acute Care · Pre-internship · common

A 68-year-old man taking gliclazide modified release for type 2 diabetes is found drowsy with a blood glucose concentration of 2.1 mmol/L. He improves after int…

Emergency and Toxicology · Clinical rotations · middle twist

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and deep breathing. Her blood glucose concentration is 24 mmol/L, venous pH is 7…

Endocrine and Metabolic · Clinical rotations · middle twist

A 68-year-old man with chronic kidney disease presents with weakness after spironolactone was added to his medicines. His serum potassium is 7.0 mmol/L (3.5–5.2…

Cardiovascular · Clinical rotations · common

A 63-year-old woman with type 2 diabetes accidentally injects 60 units of insulin glargine instead of her usual 20 units. She becomes confused with a capillary…

Emergency and Toxicology · Clinical rotations · common

A 28-year-old man with type 1 diabetes uses a continuous subcutaneous insulin infusion. He develops nausea after the pump gives an occlusion alarm; his blood gl…

Endocrine and Metabolic · Clinical rotations · common

A 74-year-old man with type 2 diabetes presents with several days of lethargy and increasing confusion. His blood glucose concentration is 42 mmol/L, calculated…

Emergency and Toxicology · Pre-internship · common

A 31-year-old woman with type 1 diabetes is being treated for diabetic ketoacidosis with intravenous insulin and 0.9% sodium chloride. Four hours later, her blo…

Endocrine and Metabolic · Clinical rotations · common

A 67-year-old woman with type 1 diabetes is admitted with community-acquired pneumonia and is not eating. She normally injects insulin glargine 24 units at nigh…

Emergency and Toxicology · Clinical rotations · common

A 24-year-old man with type 1 diabetes presents with vomiting and abdominal pain. His blood glucose concentration is 28 mmol/L, blood ketones are 6.4 mmol/L and…

Endocrine and Metabolic · Clinical rotations · middle twist

A 72-year-old man with diabetic kidney disease takes perindopril and spironolactone. He has a serum potassium concentration of 6.2 mmol/L (3.5–5.2), chloride 11…

Renal, Urology and Electrolytes · Clinical rotations · middle twist

A 68-year-old man with chronic kidney disease is admitted with pneumonia and has received intravenous fluids, calcium gluconate and insulin with glucose for a s…

Renal, Urology and Electrolytes · Clinical rotations · middle twist

A 79-year-old man has fallen three times in two months, usually when walking to the toilet at night. He has slowed reactions and feels unsteady for several hour…

Geriatrics and Palliative Care · Pre-internship · common

A 29-year-old woman at 29 weeks has gestational diabetes managed with dietary advice and exercise. For the past 2 weeks, her fasting capillary glucose concentra…

Obstetrics and Gynaecology · Clinical rotations · middle twist

A 29-year-old woman with type 1 diabetes refuses her evening insulin after becoming convinced that the injections are being used to poison her. She can repeat t…

Ethics and Professional Practice · Pre-internship · common

A 24-year-old woman with type 1 diabetes on a basal-bolus insulin regimen is an inpatient awaiting elective surgery scheduled for the afternoon. Mid-morning she…

Nursing · Clinical rotations · common

A 76-year-old man with newly diagnosed type 2 diabetes is being discharged on a nightly basal insulin. The nurse has explained and demonstrated the injection te…

Nursing · Clinical rotations · common