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A 66-year-old woman was admitted with carpopedal spasm. During the previous week she had had 2 days of diarrhoea following treatment with ciprofloxacin for a urinary tract infection. She had long-standing rheumatoid arthritis treated with prednisolone 5 mg daily, and was also taking alendronic acid, omeprazole and furosemide. Investigations: serum...

A 52-year-old man had been found to have type 1 diabetes mellitus at the age of 25. He had developed retinopathy at the age of 31 and a painless foot ulcer at the age of 40. His renal function had subsequently deteriorated. On examination, urinalysis showed protein 1+, glucose 2+....

A 17-year-old boy with a 10-year history of type 1 diabetes mellitus was admitted with diabetic ketoacidosis after a night of binge drinking. He was treated appropriately with a fixed-rate intravenous insulin infusion and intravenous sodium chloride 0.9%. Twenty-four hours after admission, he was eating and drinking normally. He was...

A 20-year-old man presented with a 6-month history of lethargy and weakness. His brother had been found to have adrenal failure at the age of 18. He had two sisters who were well and there was no other family history of endocrine autoimmune disease. On examination, his blood pressure was...

A 46-year-old South Asian man presented with a 2-month history of dry mouth and polyuria. He had hypertension treated with bendroflumethiazide. There was no family history of diabetes mellitus, but his father had died suddenly during lower limb angioplasty at the age of 51. On examination, the patient’s pulse was...

A 17-year-old girl presented with primary amenorrhoea. She had grown and developed normally. There was no history of galactorrhoea or hirsutism. On examination, her height was 1.69 m, her weight was 68.3 kg, and her body mass index was 23.9 kg/m2 (18C25). She had stage 5 breast development and stage...

A 23-year-old woman was found to have type 1 diabetes mellitus following a short history of polyuria, polydipsia and unintentional weight loss. She started taking insulin aspart before meals and insulin detemir daily. What is the most appropriate time from diagnosis to start screening for microalbuminuria?A . 1 yearB ....

An 18-year-old man with cystic fibrosis was referred to clinic. Over recent months his lung function had deteriorated and he had lost weight. He was being treated for a chest infection at the time of the consultation. Investigations: oral glucose tolerance test (75 g): fasting plasma glucose8.2 mmol/L (3.0C6.0) 2-h...

A 44-year-old man was referred for investigation of cortisol excess. He had poorly controlled hypertension, and a long history of type 2 diabetes mellitus with retinopathy and peripheral neuropathy. His medication comprised aspirin, ramipril, atenolol, carbamazepine, metformin and simvastatin. Initial investigations: serum cortisol (09.00 h)350 nmol/L (200C700) serum cortisol (22.00...

A 72-year-old woman presented with a painless swelling in the front of the neck, which she had first noticed 2C3 months previously. She was otherwise well, with no symptoms of mass effect in her neck, and was not taking any medication. On examination, her thyroid gland was moderately enlarged, and...