Quiz 8: Glucose control and hypoglycaemia

Question 1

Glucose is stored in the body as glycogen in:

The brain
The red blood cells
The liver
Fat

Answer 1

The liver

Question 2

In the healthy newborn infant the blood glucose concentration is:

Lower than a normal adult
The same as a normal adult
Higher than a normal adult
Higher than a normal child

Answer 2

Lower than a normal adult

Question 3

The normal blood glucose concentration in a newborn infant is:

Less than 2.0 mmol/l

2. 0 mmol/l to 7.0 mmol/l
3. 5 mmol/l to 10.0 mmol/l
4. 0 mmol/l to 15 mmol/l

Answer 3

2.0 mmol/l to 7.0 mmol/l

Question 4

The definition of severe hypoglycaemia is a blood glucose concentration:

Less than 7.0 mmol/l
Less than 5.0 mmol/l
Less than 2.0 mmol/l
Less than 1.5 mmol/l

Answer 4

Less than 1.5 mmol/l

Question 5

Hypoglycaemia is dangerous as it may cause:

Jaundice
Brain damage
Anaemia
Bleeding

Answer 5

Brain damage

Question 6

Which of the following problems is likely to cause hypoglycaemia because the infant has an increased breakdown of glucose?

A skin temperature below 36°C

An intraventricular haemorrhage

Jaundice

Bruising

Answer 6

A skin temperature below 36°C

Question 7

The following infants are at high risk of hypoglycaemia as they have increased energy (glucose) requirements:

Infants with recurrent apnoea

Infants born after 37 weeks gestation

Infants with respiratory distress

Infants with jaundice

Answer 7

Infants with respiratory distress

Question 8

Infants born to diabetic women are at risk of hypoglycaemia because they commonly have:

Increased secretion of insulin

Decreased secretion of insulin

No secretion of insulin

No pancreas

Answer 8

Increased secretion of insulin

Question 9

The following infants are at an increased risk of hypoglycaemia:

Female infants
Male infants
Wasted infants
Term infants

Answer 9

Wasted infants

Question 10

Hypoglycaemia:

Always presents with clinical signs.

Never presents with clinical signs.

May present with clinical signs.

Usually kills the infant.

Answer 10

May present with clinical signs.

Question 11

Hypoglycaemia may present with:

Jaundice
Convulsions
Pyrexia
Oedema

Answer 11

Convulsions

Question 12

What should be given as the first feed to a healthy, preterm infant of 1850g?

Sterile water
A milk feed
A 5% glucose feed
A 50% glucose feed

Answer 12

A milk feed

Question 13

To prevent hypoglycaemia you should routinely start feeding term infants:

Immediately after delivery
At 1 hour after delivery
At 3 hours after delivery
At 6 hours after delivery

Answer 13

Immediately after delivery

Question 14

If a newborn infant had severe hypoglycaemia in a rural clinic with very limited facilities, which form of treatment should you give?

Give a feed of 50% dextrose.

Give a feed of cow’s milk and sugar if the mother has no breast milk.

Not feed the infant but send the mother and infant to the nearest hospital for an intravenous infusion.

Advise the mother to take the infant home.

Answer 14

Give a feed of cow’s milk and sugar if the mother has no breast milk.

Question 15

Severe hypoglycaemia in a preterm infant is best treated by:

Feeding the infant with breast milk

Giving 5% dextrose by nasogastric tube

Giving an intravenous bolus of 25% dextrose

Starting an intravenous infusion of 10% dextrose

Answer 15

Starting an intravenous infusion of 10% dextrose

Question 16

In hospital you are unable to find a suitable vein to start an intravenous infusion in a 4000g infant of a diabetic woman. The infant has severe hypoglycaemia. Would you:

Pass an umbilical vein catheter and start a 10% dextrose solution

Give a 5% dextrose feed

Cool the infant to conserve energy

Start antibiotics

Answer 16

Pass an umbilical vein catheter and start a 10% dextrose solution

Question 17

If an infant develops severe hypoglycaemia you should:

Repeat the blood glucose measurement in 30 minutes to assess whether it has improved.

Treat the hypoglycaemia immediately.

Refer the infant to the nearest newborn intensive care (level 3) unit.

Try to contact a more senior staff member to treat the infant.

Answer 17

Treat the hypoglycaemia immediately.

Question 18

In an infant being treated for severe hypoglycaemia, when should regular blood glucose concentration measurements with reagent strips be stopped?

Once the intravenous dextrose infusion is started

As soon as the blood glucose concentration returns to normal

Only after 5 days

When the infant has been weaned from intravenous dextrose to milk feeds

Answer 18

When the infant has been weaned from intravenous dextrose to milk feeds

Question 19

A very high blood glucose concentration:

Helps the infant to grow rapidly.

Causes glycosuria which may result in the infant becoming dehydrated.

Is common in newborn infants of diabetic mothers.

Is caused by feeding the infant too frequently.

Answer 19

Causes glycosuria which may result in the infant becoming dehydrated.

Question 20

Hyperglycaemia as a complication of an intravenous infusion of 10% dextrose or Neonatalyte is usually seen in:

Wasted infants
Preterm infants
Postterm infants
Infected infants

Answer 20

Preterm infants