Case of the Month: Pediatric ESAP

pediatric esap

This issue highlights Pediatric Endocrine Self Assessment Program. Test your clinical knowledge and prepare for your exam. Available on the online store.


Clinical Vignette

In clinic you are seeing a 14-year-old African American boy who is obese (BMI = 31 kg/m2). He has a family history of type 2 diabetes mellitus in his father and maternal grandfather. On physical examination, you note central obesity and marked acanthosis nigricans. His fasting blood glucose concentration is 101 mg/dL (5.61 mmol/L) (reference range, 70-110 mg/dL [3.88-6.11 mmol/L]), and his blood pressure is 134/86 mm Hg.

Which of the following findings is the greatest predictor of insulin resistance in this child?

  1. Normal insulin concentration
  2. Elevated LDL-cholesterol concentration
  3. Elevated triglyceride concentration
  4. Elevated small, dense LDL particle number
  5. Elevated HDL-cholesterol concentration


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