Flashcards in Hypoglycemia Deck (18)
which hormones increase serum glucose?
how do you differentiate hypoglycemia due to overproduction or getting too much exogenous insulin?
what is the normal response of the alpha cells of the pancreas to decreasing glucose levels?
increase in glucagon
what does glucagon do to the liver and adipose tissue in response to low glucose levels?
liver - stimulation of glycogenolysis and gluconeogenesis
adipose tissue - stimulates fat breakdown
how does hypoglycemia relate to the adrenergic system?
activates adrenergic response
what are the autonomic signs and symptoms of hypoglycemia?
what are the neuroglycopenia signs and symptoms of hypoglycemia?
mental status changes
lack of concentration
what are the etiologies of post prandial hypoglycemia?
- post gastric resection
- islet cell tumor
- glycogen storage disease
- hereditary fructose intolerance
how does alcohol affect gluconeogenesis? how does it affect glycogenolysis? what is the overall effect?
alcoholics can flood their serum with glucose, but cannot replenish it
what is the whipple triad?
- relief of symptoms after restoration of normoglycemia
patients who are found to have hypoglycemia at time of diagnosis should have what blood tests done?
- C peptide
- beta hydroxybutyrate
what is the rationale for a 72 fast?
- a normal person should be able to regulate their blood glucose over this time period
- someone with an insulinoma will have an overproduction of insulin and become symptomatic
what are the provocative tests for diagnosing hypoglycemia?
what imaging is done for hypoglycemia?
- abdominal CT or MRI
- ultrasound, transabdominal or endoscopic
- arterial calcium stimulation: to distinguish focal abnormality vs diffuse process
what test is used to distinguish focal abnormality vs diffuse process?
arterial calcium stimulation
what is the acute management for hypoglycemia?
- oral glucose IF patient is conscious
- IV glucose 50% followed by IV drip dextrose
- glucagon IV or SQ
what is the treatment for an islet cell tumor?