Pre-Test Case Presentation

Tunde, a 55 year old man, is a new patient to your practice. During your consultation, Tunde admitted to shortness of breath on exertion, extreme thirst, and some numbness in his toes.

Due to his work schedule he often ate late from a street vendor emphasizing his favorite dish of fried chicken, usually with a bottle of beer, followed by a cigarette.

On exam, Tunde had a body mass index of 38 kg/m2, diastolic blood pressure of 95 mmHg, systolic blood pressure of 158 mmHg and pigmentation to his neck indicative of acanthosis nigricans.

You recommend a blood test and schedule a follow-up consultation in 2 weeks.