A 22-year-old woman with type 1 diabetes mellitus and mild asthma comes to the physician for a follow-up examination. She has had several episodes of sweating, dizziness, and nausea in the past 2 months that occur during the day and always resolve after she drinks orange juice. She is compliant with her diet and insulin regimen. The physician recommends lowering her insulin dose in certain situations. This recommendation is most important in which of the following situations?
AAfter a stressful exam
BDuring a viral infection
CBefore exercise
DAfter large meals
EDuring pregnancy
A 10-year-old boy is brought to the emergency department by his mother due to frequent vomiting, abdominal pain, and weakness. Over the last 5 days, has been noted to have polydipsia and polyuria. Family history is irrelevant. His temperature is 37.1°C (98.7°F), blood pressure is 100/70 mm Hg, and pulse is 110/min. Physical examination reveals no response to verbal commands, sunken eyes, poor skin turgor, and rapid deep respirations. Laboratory results are shown: Random plasma glucose 420 mg/dL Serum beta-hydroxybutyrate elevated Fasting C-peptide undetectable Antiglutamic acid decarboxylase (GAD) antibodies positive This patient's condition occurs as a result of which of the following?
AInsulin resistance
BStarvation
CImmune-mediated destruction of pancreatic beta cells
DDefective synthesis or release of arginine vasopressin
ESalicylate poisoning
A 13-year-old girl presents after losing consciousness during class 30 minutes ago. According to her friends, she was doing okay since morning, and nobody noticed anything abnormal. The patient’s mother says that her daughter does not have any medical conditions. She also says that the patient has always been healthy but has recently lost weight even though she was eating as usual. Her vital signs are a blood pressure of 100/78 mm Hg, a pulse of 89/min, and a temperature of 37.2°C (99.0°F). Her breathing is rapid but shallow. Fingerstick glucose is 300 mg/dL. Blood is drawn for additional lab tests, and she is started on intravenous insulin and normal saline. Which of the following HLA subtypes is associated with this patient’s most likely diagnosis?
ADR3
BA3
CB8
DDR5
EB27
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