EXAM #2: HYPOGLYCEMIA Flashcards
List the hormones that raise serum glucose.
1) Glucagon
2) Cortisol
3) GH
4) Adrenaline
5) NE
How can you tell the difference between too much endogenous vs. exogenous insulin?
Endogenous= insulin + c-peptide Exogenous= insulin only
What is the effect of insulin on K+ and phosphate?
Increased uptake of K+ and phosphate
How can kyperkalemia be treated?
Insulin + glucose
What are the symptoms of hypoglycemia?
STAB AT
- Sweating*
- Tremors
- Agitation/anxiety*
- Blurry vision
- AMS
- Tachycardia*
*These symptoms are related to the ANS; others are neurologic.
What is the most common cause of hypoglycemia in adults?
1) DM therapy, esp. insulin therapy in T1DM
What is the most common cause of hypoglycemia in non-diabetic patients?
1) Alcohol
2) Critical illness
3) Hormone deficiency
*Don’t forget inappropriate psych self med. with insulin
What is the effect of alcohol on blood sugar?
- Gluconeogenesis is inhibited
- Glycogenolysis is activated
What are the critical illnesses that can cause hypoglycemia?
1) Hepatic, renal, or cardiac failure
2) Sepsis
What is the most common cause of hypoglycemia caused by endogenous hyperinsulinemia?
Insulinoma
What causes post-pradial hypoglycemia?
1) S/p gastric resection
2) Islet cell tumor
3) Glycogen Storage Disease
4) Hereditary fructose intolerance
5) Galactosemia
What are the two major medications associated with hypoglycemia?
1) Gatifloxacin
2) Indomethacin
What is the Whipple Triad?
Triad of symptoms associated with an insulinoma:
1) Fasting glucose less than 40 mg/dL
2) Symptomatic
3) Immediate relief of symptoms after glucose infusion
What oral glucose medication can cause elevated levels of endogenous insulin and c-paptide?
Sulfonylurea
What are the expected lab findings in a patient with hypogylcemia due to exogenous insulin overdose?
1) insulin greater than 3
2) c-peptide less than 0.2
