Darrow hypoglycemia Flashcards Preview

endoII exam2 > Darrow hypoglycemia > Flashcards

Flashcards in Darrow hypoglycemia Deck (21):
1

What is Whipples triad

Sx and signs hypoglycemia
low glcose at time of event <50
reversal with correction hypoglycemia
= INSULINOMA

2

what are signs of hypoglycemia

confusion, sweating, tachycardia

3

neuroglycopenic signs hypoglycemia

blurred vision, fatigue, dizziness, HA, confusion, seizures, coma death

4

what are the sympathoadrenal signs of hypoglycemia

sweating, tachy, tachypnea, anxiety, tremulousness, nausea

5

patient has hypoglyemic signs and bitemporal hemianopsia
what are you looking for?

MEN syndrome

6

what will serum insulin be if glucose is <50

less than 5 uU/mL

7

if inject insulin will you detect C peptide

no!

8

if suspect insulin cause of hypoglycemia what test is good to do

serum beta hydroxybutyrate which should be low (<2.7)

9

insulinoma labs

high C peptide
proinsulin is high
Na and K normal
Ca elevated
PRL high
T4 normal

10

80% insulinomas are wehre

benign pancreatic ademoas

11

what are used to Ca stimulate angiography

tobutamide, glucagon and leucine

12

Tx for insulinomas

surgery, frequent feedings, diazoxide, verapamil, octreotide

13

how does diazoxide work

opens K channel

14

how does verapamil work

Ca Ch blocker

15

non DM F passed out
glucose 30 insulin 7 (normal)
C peptide present
what lab next?

serum sulfonylurea level

16

25 M with confusion after eating
low glucose
high insulin and C peptide and proinsulin
next test?

72 hour fast to produce hypoglycemia

17

25 M with confusion after eating
low glucose
high insulin and C peptide and proinsulin
72 hr test fails to produced hypoglycemia
abdominal US -
Dx?

nesidioblastosis (hyperplasia beta cells)

18

Causes of Hypoglycemia

Renal disease
Exogenous drugs
Pituitary insufficiency, Pregnancy
Liver fialure
Adrenal insufficiency, Alcohol
Islet cell tmors
Neoplasms
Sepsis

19

Drugs that cause hypoglycemia

Sulfonylureas, meglitinides
Alcohol, ASA, Antidysrrhythmics (quinine) Antibiotics, Antimalarials, Acetaminophen overdose
Pentamidine

20

with low glucose <50 what shoul dinsulin be

low

21

hypoglycemia after meal

nesidioblastoma