Hypoglycemia Flashcards Preview

Endocrinology > Hypoglycemia > Flashcards

Flashcards in Hypoglycemia Deck (11):
1

Hypoglycemia def

  • most common value < 70 mg/dl
  • signs not common until glucose < 50 mg/dl

2

Causes of Hypoglycemia

  1. Insulinoma
  2. Extrapancreatic tumors
  3. Addison's 
  4. Liver disease
  5. Sepsis
  6. Insulin O.D.
  7. Starvation (young)
  8. xylitol intoxication

3

Clinical signs of hypoglycemia

  • anxiety
  • tachycardia
  • bizarre behavior
  • weakness and ataxia
  • muscle twitching
  • dementia
  • seizures

4

Insulin OD TX

  1. Glucose: 0.5 gm/kg
    • no effect if too late
  2. Karo syrup orally: 1ml = 1gm = 1/2 ml/kg
  3. dextrose 50% = 0.5 gm/ml = 1 ml/kg IV push
    • dont OD a 1 pound puppy*****
  4. Glucagon: 0.25 to 1.0 mg IM or 0.03 mg/kg IM
    • brain insurance

5

Insulinoma

  • Bad dz in animals
  • look for mets => LIVER
  • Midde-aged and older animals
  • endocrine tumors are dark (highly vasculurized)
  • episodic neuroglycopenia
    • hypoglycorachia (low BG in CSF)
  • DX by hypoglycemia with inapp inc insulin in blood
    • ratio > 50 suggests insulinoma in appropriate clin setting

6

Insulinoma

Medical therapy

  1. Frequent feeding
  2. Diazoxide
  3. Prednisone

7

Pediatric Hypoglycemia

Emergency dose of dextrose

  • 50% dextrose 1 mL/kg

8

Hypoglycemia in sepsis

  • Gram negative bact and endotoxins
  • mechanisms
    • inhibits gluconeogenesis
    • Hepatic Glycogen depletion
    • Shift to Anaerobic metabolism

*dysregulated diabetics are susceptible to infection

  • routine veinopuncture turns gross necrotic wound

9

Paraneoplastic hypoglycemia

fix by taking out tumor

10

Hypoglycemia of pregnancy

  • rare
  • normalize BG

11

Addisonian hypoglycemia

  • no steroids
  • lack gluconeogenesis