Diabetes Mellitus USMLE Step 1 Practice Question
A 54-year-old obese man with hypertension and dyslipidemia presents with fatigue. Vital signs show BP 148/92 mmHg, HR 88/min, RR 16/min, temperature 37°C, and SpO2 98% on room air. Fasting glucose is 168 mg/dL; hemoglobin A1c is 8.1%. Random urinalysis shows no ketones. He takes lisinopril and atorvastatin but denies polyuria or polydipsia. Which of the following best describes the pathophysiology of his most likely disease?
Answer choices
- APeripheral insulin resistance with progressive beta cell dysfunctionCorrect answer
- BExcess cortisol secretion causing acute ketoacidosis
- CAutoimmune destruction of beta cells causing absolute insulin deficiency
- DLack of ADH secretion from the posterior pituitary
- EMutation in the RET proto-oncogene
- FLatent autoimmune diabetes in adults (LADA)
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