Hypoglycemia

Question 1

what four things will increase with hypoglycemia?

Answer 1

glucagon
epi
growth hormone
cortisol

Question 2

what goes down with hypoglycemia?

Answer 2

insulin

Question 3

what level of sugar is quantified as true hypoglycemia?

Answer 3

less than 50

Question 4

what are the autonomic symptoms of hypoglycemia?

Answer 4

diaphoresis
shaky
palpitations
anxious
parasthesia
hungry

Question 5

what are the neuroglycopenic symptoms of hypoglycemia?

Answer 5

weak/tired
lack concentration
dizzy
blurred vision
coma
seizure

Question 6

what is the hypoglycemia triad?

Answer 6

symptoms of hypoglycemia
confirmed lab result
resolution of symptoms with admin of glucose

Question 7

if a neonate has hypoglycemia with high insulin, what four things can be considered?

Answer 7

insulinoma
maternal diabetes
congenital hyperinsulinism
drugs (insulin use)

Question 8

what is congenital hyperinsuilinism?

Answer 8

mutation in K+ATPase

Question 9

if adult has hypoglycemia and insulin is low…what are possible causes?

Answer 9

drugs
hormonal deficiency
critical illness
non islet cell tumors

Question 10

how can non islet cell tumors produce low insulin hypoglycemia?

Answer 10

they secrete IGF-2 (insulin like growth factor), which can bind insulin receptors but is not measured in insulin measurements

Question 11

what critical illnesses can cause hypoglycemia with low insulin?

Answer 11

liver failure
renal failure
sepsis

Question 12

what two hormonal changes can cause hypoglycemia with low insulin?

Answer 12

low cortisol and growth hormone

Question 13

what two drugs can cause low insulin hypoglycemia?

Answer 13

alcohol and slaicylates

Question 14

what drug can cause high insulin hypoglycemia?

Answer 14

insulin and sulfonyureas

Question 15

what tumor can cause high insuliin hypoglycemia?

Answer 15

insulinoma

Question 16

what are the four measurements to make in hypoglycemia management?

Answer 16

glucose
insulin
C-peptide
sulfonylurea screen

Question 17

how long is an observed fast to induce hypoglycemia?

Answer 17

72 hours max

Question 18

what is C peptide?

Answer 18

pre insulin peptide…signal endogenous production of insulin

Question 19

if C peptide is low but insulin is high…what do we think?

Answer 19

patient giving themselves insulin

Question 20

if C peptide is high nd insulin is high…what do we think?

Answer 20

insulinoma

Question 21

what happens to persons weight in insulinoma?

Answer 21

gain

Question 22

does insulinoma induce hypoglycemia during postprandial or fasting time?

Answer 22

usually fasting

Question 23

what is rx choice for insulinoma?

Answer 23

surgery

Question 24

what are the 3 causes of postprandial hypoglycemia to be aware of?

Answer 24

postgastrectomy
occult diabetes
isiopathic postprandial syndrome

Question 25

what test is administered to evaluate postprandial hypoglycemia?

Answer 25

mixed meal test

Question 26

what is a mixed meal test?

Answer 26

give food and watch sugar…checking for hypoglycemia

Question 27

what is pathophys of postgastrectomy causing hypoglycemia?

Answer 27

rapid gastric emptying and influx of carbs to intesting causes overproduction of incretins and more insulin release than needed

Question 28

what is rx for postgastrectomy hypoglycemia?

Answer 28

small frequent meals

Question 29

explain the pathophys behind occult diabetes causing postprandial hypoglycemia

Answer 29

delayed but exaggerated insulin response in early diabetes…so you dont get the early push of insulin but later on after meal you get more than usual and this induces hypoglycemia

Question 30

what is rx for occult diabetes postprandial hypoglycemia

Answer 30

small meals

Question 31

what is idiopathic postprandial syndrome?

Answer 31

symptoms of hypoglycemia develop at random times following meals…no identifiable causes