ALL INDIA PG MEDICAL 2015 - DIABETES
Dr. Rajendran Rajendran
ALL INDIA PG MEDICAL 2015 - DIABETES
Dr. RAJENDRAN’S INSTITUTE OF MEDICAL EDUCATION


ALL INDIA 2015 MEDICINE – DIABETES (9)

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1) Not associated with diabetes mellitus-

a. Cushing syndrome

b. Acromegaly

c. Hypothyroidism

d. Pheochromocytoma



Ans: (c)

DIABETES MELLITUS SECONDARY TO OTHER CAUSES


Secondary causes of hyperglycemia.

Hyperglycemia due to tissue insensitivity to insulin
• Hormonal tumors (acromegaly, Cushing syndrome, glucagonoma, pheochromocytoma, hyperthyroidism)
• Pharmacologic agents (corticosteroids, sympathomimetic drugs, niacin)
• Liver disease (cirrhosis, hemochromatosis)
• Muscle disorders (myotonic dystrophy)
• Adipose tissue disorders (lipodystrophy, truncal obesity)
• Insulin receptor disorders (acanthosis nigricans syndromes, leprechaunism)

Hyperglycemia due to reduced insulin secretion
• Hormonal tumors (somatostatinoma, pheochromocytoma)
• Pancreatic disorders (pancreatitis, hemosiderosis, hemochromatosis)
• Pharmacologic agents (thiazide diuretics, phenytoin, pentamidine, calcineurin inhibitors)



? Diabetes Mellitus & Hypoglycemia > 7. Diabetes mellitus secondary to other causes
o Current Medical Diagnosis & Treatment 2016, Chapter 27



2) Most common oral infection in diabetes mellitus-

a. Candida

b. Aspergillus

c. Streptococcus

d. Staphylococcus



Ans: (a)

C albicans is the predominant causal organism of most candidosis. C albicans is a commensal organism inhabiting the mouths of almost 50% of the population (carriers). Candida is an opportunistic infection and typically occurs where the local ecology is disturbed, or where there is an immune defect. Immune defects, especially HIV infection, immunosuppressive treatment, leukemias, lymphomas, cancer, and diabetes, may predispose patients to candidal infection.



3) To make a diagnosis of gestational diabetes, post 1 hour 75 gram oral GTT should be > ---------------------mg%

a. 140

b. 150

c. 180

d. 200



Ans: (c)

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. All pregnant women need to be screened for gestational diabetes. The timing of the screening depends on risk factor assessment. Pregnant women with no known history of diabetes are screened at 24-28 weeks gestation. Women at high risk for GDM are screened at the first prenatal visit. A 75-g 2-hour OGTT is the test of choice in both groups.

The 75-g Glucose OGTT is best performed after an overnight fast; the diagnosis is made if fasting plasma glucose is documented at 92mg/dL or higher, a 1-hr plasma glucose of 180 mg/dL or higher, or a 2-hr plasma glucose of 153 mg/dL or higher. The diagnosis of gestational diabetes is confirmed with a minimum of one abnormal value.

Fifth International Workshop Conference on Gestational Diabetes: Diagnostic Criteria of Gestational Diabetes by Oral Glucose Tolerance Testing

Oral Glucose Load
Time 100-g Glucose 75-g Glucose
Fasting 95 mg/dL 5.3 mmol/L 95 mg/dL 5.3 mmol/L
1-hr 180 mg/dL 10.0 mmol/L 180 mg/dL 10.0 mmol/L
2-hr 155 mg/dL 8.6 mmol/L 155 mg/dL 8.6 mmol/L
3-hr 140 mg/dL 7.8 mmol/L — —

Two or more of the venous plasma glucose concentrations listed must be met or exceeded for a positive diagnosis.

? Diabetes Mellitus > National Institutes of Health Consensus Development Conference on Diagnosing Gestational Diabetes Mellitus
o Williams Obstetrics, 24e, Chapter 57
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