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17 Cards in this Set
- Front
- Back
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Most important event from transition from fetal to neonatal life is _________.
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Adaptation from environment where glucose is readily available (from maternal blood) to environment where glucose is limited and intermittent (eating)
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Hormonal changes at birth.
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Increased glucagon
Dec'd insulin Inc'd catechol and GH Induces: Glycogenlysis, glucneo, lipolysis, and ketogenesis |
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Which hormones are balanced during euglycemia?
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Insulin balanced with GH, Cortisol, and Glucagon
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Which hormones predominate during hypoglycemia?
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LOTS of insulin
Little GH, Cortisol, Glucagon |
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Definition of hypoglycemia
Include lab value and symptoms. |
Glucose <40
Syx: subtle in babies May be apnea, resp distress, poor feeding, myoclonic jerks, seizures, somnolence, subnormal temp, sweating |
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The following are risk factors for ________:
Twins Prematurity Diabetic Mother Small for Gestational Age |
Transient neonatal hypoglycemia
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Persistent Hypoglycemia:
Differential |
CONSIDER EDITING THIS CARD
Hyperinsulinism (genetic) Hormone Deficiency: panhypopit, isolated GH def, ACTH, gluc, epi deficiencies Limited Substrates (glycogen storage disease, defect in glucneo) Disorders of FA oxidation Drug/tosin Sepsis Genetic Dz (Beckwith Wiedemann Syndrome) |
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Hypoglycemia:
Endocrine Causes vs Metabolic Causes |
Endocrine:
Hypopit Isolated GH deficiency Adrenal Insuff Hyperinsulinism Metabolic causes: MANY |
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Midline defect and micropenis are signs of ______.
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Hypopituitarism
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Hepatosplenomegaly is a sign of ____.
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Glycogen Storage Disease
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Genetic causes of persistent hyperinsulinemic hypoglycemia.
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Inactivating mutations ABCC8, KCNJ11 (potassium channel remains closes, leaving Ca2+ open, and insulin constantly released)
Activating mutations GLUD1 (glutamate dehydrogenase--involved in insulin secretion) |
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Treatment for hyperinsulinemic hypoglycemia.
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Diazoxide (binds ABCC8 subunit of K-ATP channel, opens channel, inhibits insulin release)
Ocreotide inhibits beta-cell release of insulin Surgery (last resort) |
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Which hormones predominate in hyperglycemia?
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HIGH GH, Cortisol, Glucagon
Low Insulin |
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Neonatal DM:
Definition Genetic Associations with Transient Disease Genetic Associations with Permanent Disease |
Hyperglycemia within first month of life, lasting over 2 weeks
Abnormalities in chrom 6, complete or partial paternal UPD--maternal chrom 6 is lost Permanent: homozygous mutation in Pdx-1 or IPF-1; defect in K+-APT channel so that channel is open (ACTIVATING mutation), never release insulin |
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Treatment for Permanent Neonatal DM
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Sulfonylureas (glyburide)
(no need for insulin!!) |
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Genetic abnormalities in Transient Neonatal DM.
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Chrom 6
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Genetic abnormalities in Permanent Neonatal DM.
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Kir 6.2
SUR1 |
