Lecture 13: Hypoglycaemia

Question 1

what blood sugar level is hypoglycaemic

Answer 1

• below 4mM

- below 72 mg/dL

Question 2

signs and symptoms of hypoglycaemia

Answer 2

• sweating
• tachycardia
• agitation
• changes in mood
• faintness
• numbness in arms and hands
• blurred vision
• confusion

Question 3

when does loss of consciousness occur

Answer 3

2.5 mM or 45 mg/dL

Question 4

causes of hypoglycaemia

Answer 4

• exercise
• fasting
• excess exogenous insulin
• insulinoma
• inhibition of endogenous glucose production eg due to alcohol
• hypernatraemia
• hypovolaemia
• pathologies eg adrenal insufficiency

Question 5

when does alcohol induced hypoglycaemia occur

Answer 5

• several hours after alcohol ingestion

- on depletion of glycogen stores when blood glucose is reliant on hepatic gluconeogenesis

Question 6

what ratio does alcohol metabolism result in

Answer 6

NADH : NAD+ ratio

Question 7

stages of fatty liver disease

Answer 7

1) steatohepatits
2) fibrosis
3) cirrhosis

Question 8

cause of alcohol induced hepatomegaly

Answer 8

• alcohol consumption decreases activity of the proteosome
• causes accumulation of protein
• increases oxidative stress

Question 9

symptoms of alcohol induced thiamine deficiency

Answer 9

• anorexia
• irritability
• difficulties with short term memory

Question 10

causes of alcohol induced thiamine deficiency

Answer 10

• malnourishment
• ethanol interference with GI absorption
• hepatic dysfunction, hindering storage and activation to thiamine pyrophosphate

Question 11

what happens in type I glycogen storage disease

Answer 11

• von Gierke’s Diease
• deficiency in G-6-Pase
• leads to hypoglycaemia that doesn’t respond to glucagon

Question 12

what happens in type II glycogen storage disease

Answer 12

• Pompe’s Disease
• deficiency in alpha 1,4 glucosidase activity in lysosomes
• one of the most devastating

Question 13

what happens in type III glycogen storage disease

Answer 13

• Cori’s Disease
• deficiency in amylo 1,6 glucosidase
• symptoms disappear after puberty

Question 14

what happens in type IV glycogen storage disease

Answer 14

• Andersen’s Disease
• liver glycogen is unbranched and has low solubility
• one of the most severe, expectancy of 5 years

Question 15

what happens in type V glycogen storage disease

Answer 15

• muscle glycogen phosphorylase is defected
• muscle can’t break down glucose
• sufferers have low tolerance to exercise