Endocrine - Hypoglycemia Flashcards
Is hypoglycemia a disease?
No, it is an indicator of a health problem
What is the glucose level that defines hypoglycemia in an adult w/o diabetes, w/ diabetes, and newborns?
W/o diabetes <50mg/dL
w/ diabetes <70mg/dL
Newborns <40mg/dL
What are symptoms of hypoglycemia?
Irritability Sweating Palpitations Hunger Anxiety Headache Mental fullness Fatigue Seizures Loss of Consciousness
What is Wipples’ triad? What does it indicate?
Indicates hypoglycemia:
Symtoms
Plasma glucose <50
Amelioration of symptoms by resoration of normal glucose
What are 5 major causes of hypoglycemia? Which is most common?
Drug induced - most common Tumors Counterregulatory hormone deficiency Hepatic disorder Glycogen storage disease
How can ethanol induce hypoglycemia?
Inhibits gluconeogenesis by causing excess NADH that drives pyruvate to be converted to lactate, and does not allow lactate to do the other way
What is the most common tumor that causes hypoglycemia?
Insulinoma
What are examples of counter regulatory hormone deficiencies that can cause hypoglycemia?
Cortisol
GH
Catecholamines
Glucagon
What is Type I glycogen storage disease? What is deficient?
Von Gierke’s
Deficient in glucose-6-phosphate (causing increased glycogen)
What is Type II glycogen storage disease? What is deficient?
Pompe’s
Deficient in lysosomal alpha1,4glucosidase (can’t break down glycogen)
What is Type III glycogen storage disease? What is deficient?
Cori’s
Deficient in debranching enzyme (increase glycogen short outer branches)
What is Type IV glycogen storage disease? What is deficient?
Anderson’s
Deficient in branching enzyme (Long filamentous structure of glycogen)
What is Type V glycogen storage disease? What is deficient?
McArdle’s
Deficient in muscle phosphorylase (exercise intolerance)
What is Type VI glycogen storage disease? What is deficient?
Her’s
Deficient in liver phosphorylase (increased glycogen, normal structure)
What is Type VII glycogen storage disease? What is deficient?
Tarui’s
Deficient of muscle phosphofructokinase (exercise intolerance, unrelieved by glucose)
What is Type VIII glycogen storage disease? What is deficient?
Deficient of liver phosphorylase Kinase
Similar to 6, but milder
What accumulates if you are fructose intolerant? What is deficient?
Fructose-1-posphate
Deficient in Aldolase B
What is fructosuria? What is deficient? What are the consequences?
Deficient in fructokinase
Pee fructose out in urine
Benign
Why is fructose intolerance so severe?
Fructose-1-P accumulates in liver
Depletes P pool
Elevated F-1-P and decreased P inhibits phosphorlyase
Inhibits aldolase A (needed for glycolysis)
What is deficient in lactose intolerance?
Lactase
What two things can be deficient causing galactosemia? What results from each?
Galactokinase deficient - accumulation of galactitol producing cataracts
Transferase deficient - cataracts, growth failure, and mental retardation
