Hypoglycaemia Flashcards
1
Q
Whipple’s triad
A
Low plasma glucose < 3 mmol
Hypoglycaemic symptoms
Relief of symptoms when given glucose
2
Q
Hypoglycaemic symptoms
A
2.5 - 3mmol Sweating Tremor Dizziness Fatigue Palpitations
<2.5 mmol
Confusion and drowsiness
Seizures
Coma
3
Q
Presentation
A
Pallor
Sweating
Tachycardia
Tremor
Confusion - AMT less than 8
4
Q
Causes EXPLAIN and investigations
A
EXogenous drugs Pituitary insufficiency - MRI head Liver failure - LFTs Addison’s - Synacthen test Insulinoma - plasma insulin level Non pancreatic neoplasms - fibrosarcomas
5
Q
Investigations
A
Capillary blood glucose
Urine glucose
Bloods - glucose, LFTs - exclude liver failure
History - DHX
6
Q
Acute management
A
If alert and orientated:
- rapid acting - lucozade
- long acting - toast
Drowsy:
- buccal glucogel
Nill by mouth:
- 100ml 20% dextrose IV
No IV access
- IM glucagon - okay in frail patients
- lasts 90 mins and takes 10 - 15 mins to work
7
Q
Implications on driving license
A
Contact DVLA - must meet criteria
Compulsory blood glucose monitoring
8
Q
Common cause of hypoglycaemia
A
Insulin
Sulfonylurea
Exercise
Missed meals
