AANP Family Nurse Practitioner (FNP) Certification ExamDiagnosisEasy
A 48-year-old male presents with a 2-week history of nocturnal polyuria, polydipsia, and fatigue. He denies weight loss but reports increased appetite. On examination, his BMI is 32 kg/m², and blood pressure is 140/85 mmHg. Random plasma glucose is 280 mg/dL (15.5 mmol/L). Which of the following is the most appropriate initial diagnosis?
- ADiabetes Insipidus
- BType 2 Diabetes Mellitus
- CSecondary Diabetes
- DType 1 Diabetes Mellitus
Show answer & explanationAnswer & explanation
Correct answer: B. Type 2 Diabetes Mellitus
The patient's age, obesity (BMI 32), classic symptoms of polyuria and polydipsia, and a significantly elevated random plasma glucose (280 mg/dL) are all consistent with a new diagnosis of Type 2 Diabetes Mellitus.
Why the other options are wrong
- A. Diabetes Insipidus involves polyuria and polydipsia but is due to a deficiency in ADH or renal unresponsiveness to ADH, resulting in dilute urine and normal or slightly elevated blood glucose.
- C. Secondary diabetes refers to diabetes caused by other conditions (e.g., pancreatitis, Cushing's syndrome) or medications, which is not indicated in this initial presentation.
- D. Type 1 Diabetes Mellitus typically presents in younger individuals, often with more acute and severe symptoms, and is characterized by autoimmune destruction of pancreatic beta cells.
Type 2 Diabetes Mellitus
A chronic metabolic disorder characterized by high blood sugar levels due to insulin resistance and/or insufficient insulin production.
- Strongly associated with obesity and sedentary lifestyle.
- Symptoms include polyuria, polydipsia, fatigue, and blurred vision.
- Managed with lifestyle changes, oral medications, and sometimes insulin.
Memory trick: THIRSTY: Type 2, Heavy, Insulin-Resistant, Symptoms, Tests (glucose high).