USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

What triad is associated with symptoms that include adrenergic and neurological manifestations, hypoglycemia, and relief of symptoms upon glucose administration?

1. Cushing disease

2. Exogenous Corticosteroids

3. Fasting Hypoglycemia when EtOH excess

4. Whipple triad

The correct answer is: Whipple triad

The triad associated with symptoms of adrenergic and neurological manifestations, hypoglycemia, and relief of symptoms upon glucose administration is known as the Whipple triad. This triad is pertinent in diagnosing insulinoma, which is a tumor that secretes insulin excessively, leading to recurrent hypoglycemia. The components of the Whipple triad include: 1. Symptoms of hypoglycemia (which may present as nervousness, tremors, palpitations—adrenergic symptoms—as well as confusion, weakness, or seizures—neurological symptoms). 2. Biochemical documentation of hypoglycemia at the time of symptom occurrence. 3. Relief of symptoms after the administration of glucose, indicating the relationship between the glucose level and the presenting symptoms. Understanding this triad is crucial for recognizing insulinomas and distinguishing them from other causes of hypoglycemia, such as those related to adrenal insufficiency or liver failure, which would not exhibit this specific symptom relief upon glucose administration. In the context of the other choices, while Cushing disease and exogenous corticosteroids may lead to metabolic disturbances, they do not produce the specific symptom relief upon glucose administration seen in Whipple's triad. Fasting hypoglycemia in cases of ethanol excess