Darrow hypoglycemia Flashcards
What is Whipples triad
Sx and signs hypoglycemia
low glcose at time of event <50
reversal with correction hypoglycemia
= INSULINOMA
what are signs of hypoglycemia
confusion, sweating, tachycardia
neuroglycopenic signs hypoglycemia
blurred vision, fatigue, dizziness, HA, confusion, seizures, coma death
what are the sympathoadrenal signs of hypoglycemia
sweating, tachy, tachypnea, anxiety, tremulousness, nausea
patient has hypoglyemic signs and bitemporal hemianopsia
what are you looking for?
MEN syndrome
what will serum insulin be if glucose is <50
less than 5 uU/mL
if inject insulin will you detect C peptide
no!
if suspect insulin cause of hypoglycemia what test is good to do
serum beta hydroxybutyrate which should be low (<2.7)
insulinoma labs
high C peptide proinsulin is high Na and K normal Ca elevated PRL high T4 normal
80% insulinomas are wehre
benign pancreatic ademoas
what are used to Ca stimulate angiography
tobutamide, glucagon and leucine
Tx for insulinomas
surgery, frequent feedings, diazoxide, verapamil, octreotide
how does diazoxide work
opens K channel
how does verapamil work
Ca Ch blocker
non DM F passed out
glucose 30 insulin 7 (normal)
C peptide present
what lab next?
serum sulfonylurea level
