Metabolic

Question 1

Hypoglycemia Symptoms

Answer 1

Glucose < 40

Hunger

Headache

Pallor

Coma

Seizure

Altered

Nausea

Anxiety

Irritabilty

Question 2

Hypoglycemia Metabolic Labs

Answer 2

Draw while hypoglycemic

• Insulin
• C-peptide
• Cortisol
• GH
• Free fatty acids
• Lactic acid
• Urine glucose, ketones, organic acids
• LFTs and ammonia

Question 3

Hypoglycemia Treatment

Answer 3

Prevent brain damage and seizures.

D10 5-10 ml/kg

D25 2-4ml/kg

D50 1-2ml/kg

50-100 rule

Question 4

Causes of Hypoglycemia

Answer 4

1. Ketotic hypoglycemia
2. Hyperinsulinism
3. Cortisol deficiency
4. GH deficiency
5. Drugs - EtOH
6. Inborn errors
7. Glycogen storage disease
8. Sepsis
9. Pan-hypopit
10. Beckwith Wiedemann

Question 5

Hyperinsulinemia

Answer 5

• Dysregulated insulin secretion
• Excessive or inappropriate (ie when hypoglycemic)
• Transient - SGA, IDM, Hypoxia
• Focal - discrete region of adenomatous hyperplasia
• Diffuse - abnormally large islet cell nuclei

Tx

• Diazoxide
• Octretide