Signs, Symptoms, And Pathophysiology Practice Test

A 64-year-old man (86 kg) with type 2 diabetes presents with shakiness, sweating, and confusion 2 hours after lunch. Medical history: type 2 diabetes, chronic kidney disease stage 4. Current medications: glyburide 10 mg daily, metformin 500 mg twice daily, lisinopril 10 mg daily. Allergies: none. Fingerstick glucose: 48 mg/dL. Labs: SCr 2.8 mg/dL, eGFR 22 mL/min/1.73 $m^2$. What is the most likely cause of these symptoms based on the patient's medication list?

A 41-year-old man (90 kg) presents with 3 days of watery diarrhea and abdominal cramping after completing clindamycin 300 mg four times daily for 10 days for a dental infection. Medical history: none. Current medications: none besides recent antibiotic. Allergies: none. Labs: white blood cell count $14,500/mm^3$ (normal 4,000–11,000), SCr 1.0 mg/dL. Which condition is most consistent with this patient's symptoms?