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ما الاختبار الذي يجب اجرائه بشكل دوري ؟


ما الاختبار الذي يجب اجرائه بشكل دوري ؟


حالة سريرية

كتابة حرة وطرح موضوع النقاش!
A 48-year-old man, recently diagnosed with type 2 diabetes mellitus, comes to his primary
care physician's office for follow-up. He is advised on a regimen of diet and exercise with
frequent monitoring of his fasting and 2-hour postprandial blood sugars. His blood pressure is
checked on several separate occasions, and he is started on an ACE inhibitor that affords
good blood pressure control. A physical examination at this visit is within normal limits. A
fasting lipid profile, 12-lead electrocardiogram (ECG), blood urea, and creatinine are all within
normal limits. Urinalysis including microalbumin is also within normal limits. Which of the
following screening tests should be recommended in this patient, given the recent diagnosis of
diabetes?

A. 2D echocardiogram
B. Colonoscopy
C. Eye examination yearly
D. PSA yearly
E. Upper gastrointestinal endoscopy
by


Eye examination yearly

Buzz_LightYear


C. Eye examination yearly

وإذا عمره كبير شوي تانية Colonoscopy

the best's picture
the best
طالب دراسات عليا


C. Eye examination every 6 month

وإذا عمره كبير شوي تانية Eye examination every 6 month

dr-askar
السنة السادسة


صحيح

The correct answer is C. Patients with recently diagnosed type 2 diabetes mellitus
should undergo a formal ophthalmologic examination soon after the diagnosis is made
and then have yearly eye examinations thereafter. This is because some patients with
insidious onset type 2 diabetes may have diabetic retinopathy already by the time the
diagnosis of diabetes is made. In contrast, it is unusual for patients younger than the age
of 30 years with type 1 diabetes to develop retinopathy
that requires specific
ophthalmologic therapy earlier than 5 years after the onset of diabetes. In patients with
type 1 diabetes, therefore, screening eye examinations are recommended 5 years after
the diagnosis is made.

Even though diabetes and hypertension predispose to heart disease, this patient does
not have any evidence of heart disease. A routine 2D echocardiogram therefore is not
recommended (choice A).
Even though a colonoscopy (choice B) and a PSA test (choice D) are valuable
screening tests for colon cancer and prostate cancer, respectively, these screening tests
are recommended once the patient turns 50 years of age; hence, there is currently no
indication for doing these tests on this patient at this time.
An upper gastrointestinal endoscopy is not recommended for routine screening (choice
E

).

qusei
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