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Year3 Endo Conditions > Hypoglycaemia > Flashcards

Hypoglycaemia Flashcards

1
Q

What is whipple’s triad for hypoglycaemia?

A
  1. hypoglycaemic symptoms
  2. accompanying low serum glucose concentration
  3. resolution of symptoms after raising the serum glucose concentration to normal
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2
Q

What is the definition of hypoglycaemia?

A

<3mmol/L

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3
Q

What is the main cause of hypoglycaemia?

A
  1. Insulin or sulfonyurea treatment missed
  2. Missed meals
  3. Drugs (sulfonylurea, SGLT-1 inhbitros etc)
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4
Q

What are non-diabetic causes of hypoglycaemia?

A
  1. Ex: exogenous (drugs, alcohol)
  2. Pituitary insufficiency
  3. Liver failure
  4. Addison’s disease
  5. Islet cell tumours
  6. Non-pancreatic neoplasms
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5
Q

What are the autonomic signs and symptoms of hypoglycaemia?

A
  1. Diaphoresis
  2. Anxiety
  3. Tremor
  4. Hunger
  5. Generalised tingling
  6. Nausea
  7. Palpitations
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6
Q

What are the neurological symptoms and signs of hypoglycaemia?

A
  1. Confusion
  2. Irritability
  3. Blurred vision
  4. Drowsiness
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7
Q

What are possible differential diagnosis of hypoglycaemia?

A
  1. Idiopathic postprandial syndrome (pseduohypoglycaemia)

2. Insulin autoimmune hypoglycaemia

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8
Q

What investigations should you do for hypoglycaemia?

A
  1. Serum glucose
  2. LFTs
  3. RFTs
  4. Serum insulin
  5. Serum C-peptide
  6. Serum beta-hydroxybutyrate
  7. Serum sulfonylurea
  8. TSH levels
  9. Serum cortisol
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9
Q

What would serum glucose levels be like in hypoglycaemia?

A

<2.8mmol/L (<50mg/dL)

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10
Q

What would serum insulin levels be like in hypoglycaemia?

A

> 21picmol/L

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11
Q

What would serum C-Peptide levels be like in hypoglycaemia?

A

> 200picmol/L

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12
Q

What would serum beta-hydorxybutyrate be like in hypoglycaemia?

A

<2.7mmol/L

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13
Q

What would serum sulfonylurea be like in hypoglycaemia?

A

positivie

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14
Q

What would the cause of hypoglycaemia be if the insulin low or undetectable with no excess ketones?

A
  1. non-pancreatic neoplasm

2. anti-insulin receptor antibodies

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15
Q

What would the causes of hyperglycaemia be if there is high insulin with low ketones?

A
  1. alcohol
  2. pituitary insufficiency
  3. Addison’s disease
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16
Q

What is the management for hypoglycaemia? if conscious?

A
  • If awake and conscious and able to swallow:
    1. 15-20g of quick acting carbohydrate snack
    2. Oral glucose and complex carbohydrate
17
Q

What are possible complications of hypoglycaemia?

A
  1. Seizure
  2. Coma
  3. DM
18
Q

What is management of hypoglcyaemia if patient is impaired concious?

A
  1. IM GLUCAGON 1mg

2. IV 10% dextrose infusion if glucagon fails to improve symptoms

Year3 Endo Conditions (33 decks)

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