01-01-2011, 01:18 PM
A 45 yr old business man presented to ER with sudden onset of confusion, irritabilty and generalised weakness. He was walking in a park when paramedics recovered him to ER. He has already been infused dextrose, Thiamine,Naltrexone. After 15 mins in ER his confusion improved and he started talking normally. His vitals are BP 140/86, PR- 100, Temp 99F. His examinations are completely normal. His labs are as follows
WBC 7500 PMN 60
Hb 14
MCV 88
Plat 250000
LFT Albumin 2.9
GGT normal
Blood glucose on arrival 45
after 1 hour 78
Serum Insulin very high
On further questioning he admits that he takes glyburide for his diagnosed diabetes for 2 years. Which of the following will you order now to differentiate between sulfonylurea induced hypoglycemia & insulinoma?
A. Serum C peptide level.
B. Serum Insulin Antibodies.
C. Serum Pro Insulin.
D. Insulin Glucose ratio
E. CT Scan of Abdomen
F. US Scan of Abdomen
WBC 7500 PMN 60
Hb 14
MCV 88
Plat 250000
LFT Albumin 2.9
GGT normal
Blood glucose on arrival 45
after 1 hour 78
Serum Insulin very high
On further questioning he admits that he takes glyburide for his diagnosed diabetes for 2 years. Which of the following will you order now to differentiate between sulfonylurea induced hypoglycemia & insulinoma?
A. Serum C peptide level.
B. Serum Insulin Antibodies.
C. Serum Pro Insulin.
D. Insulin Glucose ratio
E. CT Scan of Abdomen
F. US Scan of Abdomen