Diabetes/Glucose

Question 1

Normal values after fasting in a child?
BSL
Insulin
B-OH-butyrate
Lactate
Cortisol

Answer 1

BSL 3
Insulin 10 (15 - 120)
B-OH-butyrate 1.5 (0.1 - 0.3)
Lactate 0.5 (0.3 - 2)
Cortisol 500 (150 - 450)

Question 2

Differential diagnosis for ketonuria?

Answer 2

Hypopituitarism, adrenal insufficiency
Amino acidopathies (MSUD)
Organic acidopathies (MMA, PA)
Glycogen storage disease (if hepatomeg without jaundice)

Question 3

Signs of hypokalaemia?

Answer 3

ECG: Flattened T waves, QRS prolongation
Skeletal muscle weakness
Ileus

Question 4

What is the most common cause of death with DKA?

Answer 4

Cerebral oedema

Question 5

Incidence of cerebral oedema in DKA?

Answer 5

1-2/100

Question 6

How do you calculate true serum Na in DKA?

Answer 6

Na + 0.3(glucose -5.5)

Question 7

Risk of a sibling developing T1DM?

Answer 7

6%

Question 8

What class of drug is metformin?

Answer 8

biguanide

Question 9

How does Metformin work?

Answer 9

Decreased glucose production from liver
Decreased glucose reabsorption
Increased glucose sensitivity

Question 10

How does gliclazide work?

Answer 10

Increased glucose production in liver

Facilitates glucose disposal in muscle and fat