Endocrine - Hypoglycemia

Question 1

Is hypoglycemia a disease?

Answer 1

No, it is an indicator of a health problem

Question 2

What is the glucose level that defines hypoglycemia in an adult w/o diabetes, w/ diabetes, and newborns?

Answer 2

W/o diabetes <50mg/dL
w/ diabetes <70mg/dL
Newborns <40mg/dL

Question 3

What are symptoms of hypoglycemia?

Answer 3

Irritability
Sweating
Palpitations
Hunger
Anxiety
Headache
Mental fullness
Fatigue
Seizures
Loss of Consciousness

Question 4

What is Wipples’ triad? What does it indicate?

Answer 4

Indicates hypoglycemia:
Symtoms
Plasma glucose <50
Amelioration of symptoms by resoration of normal glucose

Question 5

What are 5 major causes of hypoglycemia? Which is most common?

Answer 5

Drug induced - most common
Tumors
Counterregulatory hormone deficiency
Hepatic disorder
Glycogen storage disease

Question 6

How can ethanol induce hypoglycemia?

Answer 6

Inhibits gluconeogenesis by causing excess NADH that drives pyruvate to be converted to lactate, and does not allow lactate to do the other way

Question 7

What is the most common tumor that causes hypoglycemia?

Answer 7

Insulinoma

Question 8

What are examples of counter regulatory hormone deficiencies that can cause hypoglycemia?

Answer 8

Cortisol
GH
Catecholamines
Glucagon

Question 9

What is Type I glycogen storage disease? What is deficient?

Answer 9

Von Gierke’s

Deficient in glucose-6-phosphate (causing increased glycogen)

Question 10

What is Type II glycogen storage disease? What is deficient?

Answer 10

Pompe’s

Deficient in lysosomal alpha1,4glucosidase (can’t break down glycogen)

Question 11

What is Type III glycogen storage disease? What is deficient?

Answer 11

Cori’s

Deficient in debranching enzyme (increase glycogen short outer branches)

Question 12

What is Type IV glycogen storage disease? What is deficient?

Answer 12

Anderson’s

Deficient in branching enzyme (Long filamentous structure of glycogen)

Question 13

What is Type V glycogen storage disease? What is deficient?

Answer 13

McArdle’s

Deficient in muscle phosphorylase (exercise intolerance)

Question 14

What is Type VI glycogen storage disease? What is deficient?

Answer 14

Her’s

Deficient in liver phosphorylase (increased glycogen, normal structure)

Question 15

What is Type VII glycogen storage disease? What is deficient?

Answer 15

Tarui’s

Deficient of muscle phosphofructokinase (exercise intolerance, unrelieved by glucose)

Question 16

What is Type VIII glycogen storage disease? What is deficient?

Answer 16

Deficient of liver phosphorylase Kinase

Similar to 6, but milder

Question 17

What accumulates if you are fructose intolerant? What is deficient?

Answer 17

Fructose-1-posphate

Deficient in Aldolase B

Question 18

What is fructosuria? What is deficient? What are the consequences?

Answer 18

Deficient in fructokinase
Pee fructose out in urine
Benign

Question 19

Why is fructose intolerance so severe?

Answer 19

Fructose-1-P accumulates in liver
Depletes P pool
Elevated F-1-P and decreased P inhibits phosphorlyase
Inhibits aldolase A (needed for glycolysis)

Question 20

What is deficient in lactose intolerance?

Answer 20

Lactase

Question 21

What two things can be deficient causing galactosemia? What results from each?

Answer 21

Galactokinase deficient - accumulation of galactitol producing cataracts
Transferase deficient - cataracts, growth failure, and mental retardation