Hypoglycemia

Question 1

What is the primary glucose regulatory factor or first defense against hypoglycemia ?

Answer 1

DECREASE IN INSULIN SECRETION

Question 2

What is the 2nd line of defense against hypoglycemia ?

Answer 2

INCREASED GLUCAGON

Question 3

What is the 2nd line of defense against hypoglycemia ?

Answer 3

INCREASED GLUCAGON

Question 4

What is the primary glucose counter regulatory factor?

Answer 4

INCREASED GLUCAGON

Question 5

GLYCEMIC THRESHOLD FOR DECREASED INSULIN RESPONSE

Answer 5

80 - 85 mg/dL or 4.4 - 4.7 mmol/L

Question 6

What is the median age of diagnosis for insulinoma in sporadic cases? In MEN type 1?

Answer 6

Median age at presentation is 50 yo in sporadic cases; in the third decade when it is a component of MEN 1

Question 7

Size of Insulinoma

Answer 7

They are usually small.
< 2 cm in diameter in 90% of the cases

Question 8

When is exaggerated GLP 1 responses to meals seen?

Answer 8

Seen in post-gastric bypass postprandial hypoglycemia

Question 9

Pathophysiology of Exercise - induced Hypoglycemia

Answer 9

Hyperinsulinemia due to increased activity of monocarboxylate transporter 1 in beta cells

Question 10

Pathophysiology of AI Hypoglycemia

Answer 10

Caused by an antibody to insulin that binds post meal insulin and gradually dissociated with consequent late postprandial hypoglycemia

Question 11

Nesidioblastosis

Answer 11

Diffuse islet involvement with beta cell hypertrophy and sometimes hyperplasia