174 hypoglycemia Flashcards Preview

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Flashcards in 174 hypoglycemia Deck (14):
1

when should hypoglycemia be considered a possibility?

confusion, altered consciousness, seizure

2

whipple's triad

symptoms of hypoglycemia (neuro)

low plasma glucose measure precisely (not glucose monitor)

relief of symptoms when glucose is raised

3

defenses against low BG?

1 - lowers insulin
2 - increases glucaon
3 - increase Epi
later increases cortisol, GH

4

how long can liver glycogen maintain blood glucose levels?

~8 hrs

5

clinical manifestations of low BG?

diaphoresis, pallor
increased systolic BP
increased HR
confusion, LOC, death

adrenergic --> palpitations, tremor, anxiety
cholinergic --> sweating, hunger, paresthesias

6

causes of hypoglycemia in ill vs health people

ill - drugs, critical illness, hormone deficiencies, non-islet tumors

not ill - endogenous hyperinsulinim, autoimmune hypoglycemia

most common cause is DM

7

causes of hypoglycemia in ill vs health people

ill - drugs, critical illness, hormone deficiencies, non-islet tumors

not ill - endogenous hyperinsulinim, autoimmune hypoglycemia

most common cause is DM

8

what can cause low bg in DM?

insulin excess - wrong dose, skipping a meal, exercise, alcohol ingestions (blocks glucose production), renal failure (reduces insulin clearance)

9

what does ethanol do?

glocks gluconeogenesis but not glycogenolysis

10

renal failure

fails to clear insulin and reduced mobilization of gluconeogenesis precursors

11

sepsis

macrophages use glucose

12

primary insulinoma

beta-cell disorder

insulin keeps getting secreted even during low bg

dx - high insulin and C peptide during hypoglycemia

rx - surgery OR make diabetic via diazoxide

13

primary insulinoma

beta-cell disorder

insulin keeps getting secreted even during low bg

dx - high insulin and C peptide during hypoglycemia

rx - surgery OR make diabetic via diazoxide

14

rx for low bg

oral glucose/juice

IV glucose if not able to use oral

glucagon IM