STUDENT’S GUIDE

BLOK ENDOCRINE AND METABOLISM 2021/2022

SCENARIO 1
Tingling on Both Hands
A 50-year-old woman came to private doctor with complaints of tingling on both hands
which is getting worse during this week. The patient admitted that this complaint had been felt
since 6 months ago and felt intermittent throughout the day. Other complaints such as often feeling
weak, always feeling hungry and thirsty, and frequent urination that interfere the activities,
especially when resting at night. These complaints have been felt by the patient since 1 year ago.
The patient had been suffering from diabetes since 1 year ago with the results of blood
sugar examination more than 300 mg/dl. The patient were administered blood sugar-lowering
drugs and educated in the form of routine blood sugar checks and recommended diet for diabetes
mellitus. After that, the patient did not routinely check his blood sugar and control her disease.
The patient has a habit of eating high-fat foods (fried foods and snacks). The patient
admitted that she often consumes coffee with three full tablespoons of sugar every morning. The
patient also admitted that she rarely did sports. The patient's height is 150 cm, weight before DM
is ±60 kg, and current weight is 45 kg.
A physical examination was carried out and the general condition appeared to be mild,
compos mentis consciousness, blood pressure 110/70 mmHg, pulse rate 88x/minute, respiratory
rate, 20x/minute, temperature 36,50C. Physical examination revealed : head, thorax, abdomen and
both extremities are in normal limit.
Supporting examination carried out is blood sugar at a time of 490 mg/dl.
The patient was then given pharmacological therapy in the form of metformin tablets 2 x
500 mg, Glibenclamide tablets 1 x 5 mg, and Vitamin B complex tablets 2 times a day.
Discuss the scenario with seven jumps.

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