Uji Penanganan Hipoglikemia

A 62-year-old female patient with a history of diabetes mellitus for more than 6 years comes to the clinic complaining of frequent weakness and dizziness due to blood sugar levels often measured below 60 mg/dl. The patient has been using Glibenclamide 1x5 mg and the doctor plans to replace her medication. Among the following medications, which is the most appropriate to reduce the risk of hypoglycemia in this patient?

• Gliquidone

• Insulin

• Sitagliptin

• Glimepiride

• Combination of metformin and glimepiride

A 72-year-old female patient arrives at the emergency department accompanied by her family in a conscious state, complaining of weakness after taking Glibenclamide 5 mg 2 hours earlier. The patient has only eaten a little after taking the medication because she has been feeling nauseous lately. Random blood glucose examination shows a level of 55 mg/dl. What is the appropriate management for this patient?

• Administer 75 ml of 20% dextrose intravenously

• Administer 150 ml of 10% dextrose intravenously

• Administer 1 mg of glucagon intramuscularly

• Administer 150-200 ml of fruit juice orally

• Administer 50 ml of 40% dextrose intravenously

A 67-year-old male patient arrives at the emergency department in a conscious state, complaining of weakness, trembling, and cold sweat. The patient has a history of diabetes mellitus for 5 years with Glimepiride therapy 4 mg once daily before breakfast. Two hours before arriving at the emergency department, the patient consumed Glimepiride 4 mg, then ate a little bread and started exercising. After blood glucose examination, the result was 54 mg/dl. This has happened for the third time. What is the most appropriate strategy to prevent hypoglycemia?

• All diabetes patients should set their blood glucose control targets to achieve HbA1C below 6.5%

• Diabetes treatment strategies should be uniform for all diabetes patients to achieve good glycemic control

• The main choice of medication for patients at risk of hypoglycemia is a combination of insulin and sulfonylurea

• In patients at risk of hypoglycemia, sulfonylurea medications should be replaced with GLP-1 receptor agonists, DPP-4 inhibitors, or SGLT2

• In patients with recurrent hypoglycemia, blood glucose examination should not be done independently but should be done in healthcare facilities like hospitals

A 57-year-old man arrives at the emergency department with complaints of left chest pain radiating to the neck and left arm. The patient has a history of diabetes mellitus for 2 years, regularly consuming metformin 3x500 mg and glimepiride 1x4 mg. EKG examination shows ST elevation in V1-V4 and blood glucose examination shows a level of 50 mg/dl. What cardiovascular complications in the condition of hypoglycemia are triggered by?

• Increased cardiac contractility, increased platelet activation, increased IL-6

• Decreased cardiac oxygen consumption, increased vasodilation, increased cardiac contractility

• Increased platelet activation, increased IL-6, decreased cardiac oxygen consumption

• Decreased cardiac contractility, increased IL-6, decreased platelet activation

• Increased cardiac oxygen consumption, decreased cardiac contractility, decreased platelet activation

A 42-year-old woman arrives at the emergency department with...

A 42-year-old woman comes to the emergency department with a complaint of fever for 5 days. She has a history of diabetes mellitus for 2 years with insulin treatment. In recent weeks, the patient has not injected insulin and switched to herbal medicine. Physical examination shows blood pressure 110/70 mmHg, pulse 110 beats per minute, axillary temperature 38.5°C. Laboratory examination shows blood glucose 364 mg/dl; blood gas analysis with pH 7.19. Chest X-ray shows pneumonia. What is the most important initial management for this patient?

• Administer NaCl 0.45% infusion 500-1000 ml/hour

• Administer intravenous insulin bolus 0.1 U/kg and continue drip 0.1 U/kg/hour

• Administer NaCl 0.9% infusion 500-1000 ml/hour

• Administer sodium bicarbonate drip

• Administer antibiotics and take blood culture before giving antibiotics

A 70-year-old man is brought to the emergency department by his family, complaining of decreased consciousness since this morning. The patient has a history of diabetes for 20 years, using insulin for 1 year, but has not injected insulin for a week due to weakness and decreased appetite. Physical examination shows GCS E2V4M5, blood pressure 90/70 mmHg, pulse 110 beats per minute, axillary temperature 36.6°C. Laboratory examination shows plasma blood glucose 620 mg/dl, blood gas analysis with pH 7.36, potassium 3.3 mmol/L, sodium 161 mmol/L. CT scan of the head shows no abnormalities. What is the initial management priority for this patient?

• Administer NaCl 0.45% infusion 500-1000 ml/hour

• Administer intravenous insulin bolus 0.1 U/kg and continue drip 0.1 U/kg/hour

• Administer NaCl 0.9% infusion 500-1000 ml/hour

• Administer KCl drip 10-20 mmol/hour

• Administer norepinephrine drip 0.05 mcg/kg/minute

The following statement is appropriate for diabetic ketoacidosis:

• More often found in the elderly than in the young

• Blood sugar is usually above 600 mg/dl

• Often occurs in people newly diagnosed with diabetes mellitus

• The underlying pathophysiology is relative insulin deficiency

• The more prominent symptoms are decreased consciousness. Nausea, vomiting, and abdominal pain are rarely found.

One of the resolution criteria for diabetic ketoacidosis is:

• Blood glucose level below 300 mg/dl

• Serum bicarbonate 18 mEq/L

• Blood pH > 7.45

• Anion gap 12 mEq/L

• Blood glucose level above 300 mg/dl

The following is the correct management of a thyroid crisis:

• Administer PTU loading 500-1000 mg followed by 250 mg every 8 hours

• Administer propranolol 20-40 mg every 24 hours

• Administer hydrocortisone 300 mg every 8 hours

• Administer potassium iodide 250 mg every 6 hours 1 hour before PTU

• Administer methimazole 20-40 mg every 24 hours