WBR1120

Author	[[PageAuthor::Mohamed Moubarak, M.D. [1]]]
Exam Type	USMLE Step 3
Main Category	Primary Care Office
Sub Category	Endocrine, Endocrine
Prompt	A 40 year-old female presents to your office complaining of frequent urination and feeling thirsty all the time, started gradually over the last 6 months, when she also noticed her increased appetite, and weight gain. She has moved to United States three months ago with her husband. The patient has insignificant past medical history. On examination, she has normal vital signs. She is obese, no lower limb edema. She has insignificant chest and abdominal examination. Which of the following is the most appropriate diagnostic criterion for her condition?
Answer A	Two fasting glucose reading > 120 mg/dL
Answer A Explanation	[[AnswerAExp::Incorrect Diabetes mellitus is diagnosed by two fasting blood glucose measurements greater than 125 mg/dL]]
Answer B	Two fasting glucose reading > 126 mg/dL
Answer B Explanation	[[AnswerBExp::Correct Diabetes mellitus is diagnosed by two fasting blood glucose measurements greater than 125 mg/dL]]
Answer C	Two fasting glucose reading > 140 mg/dL
Answer C Explanation	[[AnswerCExp::Incorrect Two fasting blood glucose measurements greater than 125 mg/dL is one of the criterion used to diagnose diabetes mellitus.]]
Answer D	One random blood glucose >200 mg/dL even without symptoms
Answer D Explanation	[[AnswerDExp::Incorrect Single glucose level above 200 mg/dL with symptoms is required as a diagnostic criterion for diabetes mellitus.]]
Answer E	Hemoglobin A1c >5.5%
Answer E Explanation	Incorrect Hemoglobin A1c >6.5% is a diagnostic criterion and is the best test to follow response to therapy over the last several months.
Right Answer	B
Explanation	[[Explanation::The classical triad of diabetes mellitus symptoms are: Polyuria Polydipsia Polyphagia They are, respectively, frequent urination; increased thirst and consequent increased fluid intake; and increased appetite. Diabetes mellitus is diagnosed by: Two fasting blood glucose measurements greater than 125 mg/dL Single glucose level above 200 mg/dL with typical presentations of hyperglycemia. Increased glucose level on oral glucose tolerance testing Hemoglobin A1c >6.5% is a diagnostic criterion and is the best test to follow response to therapy over the last several months. Educational Objective: Diabetes mellitus is diagnosed by: Two fasting blood glucose measurements greater than 125 mg/dL Single glucose level above 200 mg/dL with typical presentations of hyperglycemia. Increased glucose level on oral glucose tolerance testing Hemoglobin A1c >6.5% is a diagnostic criterion and is the best test to follow response to therapy over the last several months. References: http://www.wikidoc.org/index.php/Diabetes_mellitus]]
Approved	No
Keyword	[[WBRKeyword::Diabetes mellitus]]
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