Endocrine - 16 - Hypoglycemia

Front 1

definition of hypoglycemia

Back 1

plasma glucose below 50

Front 2

transitional glucose

Back 2

right after birth there is a drop in glucose level and insulin level

Front 3

most important fuel during fasting

Back 3

glycogen during the first 6-8 hours for adults

gluconeogenesis using glycerol, fatty acid, alanine) after that

Front 4

substrates for gluconeogenesis

Back 4

glycerol, ketones, alanine

Front 5

gluconeogenesis

Back 5

plays a role after glycogenolysis

Front 6

decrease in glucose will see in increase in which hormones

Back 6

glucagon

epinephrine

GH

cortisol

Front 7

a glucose less than 50 will exhibit what symptoms

Back 7

impaired cognition, lethargy, confusion, incoordination, blurred vision

Front 8

what glucose level will see coma and convulsions

Back 8

30

Front 9

transitional hypoglycemia

Back 9

symptomatic or asymptomatic hypoglycemia that occurs during first 12 hours of life

due to delayed feeding

Front 10

transient hypoglycemia of infancy

Back 10

asymptomatic or asymptomatic hypoglycemia that persists beyoud the first 24 hours of life

preterm infants - have low glycogen and fat reserve - delayed maturity of the enzymes involved in gluconeogenesis

need early feeding

Front 11

infants of diabetic mothers

Back 11

are fat due to high glucose exposure -> hyperinsulin state -> fat

Front 12

diazoxide

Back 12

keeps K+ channel open on beta cells - prevents insulin secretion

Front 13

insulin secretion mechanism

Back 13

incresaed K+ depolarizes the cell

get influx of calcium

release of insulin

Front 14

hyperinsulinism

Back 14

most common form of hypoglycemia in early infancy

diffuse or focal proliferation of beta islet

Front 15

glycogen storage disease

Back 15

problem with break down of hepatic glycogen to glucose

presents as infant gets older

Front 16

GSD1

Back 16

glucose6phosphatase deficiency

most severe form of GSD

short stature with protuberant abdomen from hepatomegaly

hypoglycemia, lactic acidosis, hyperlipidemia, hyperuricidemia

avoid fasting, avoid excessive fructose, lactose, avoid corn starch

Front 17

GSD3

Back 17

deficiency debrancher amylo1,6glucosidase

failure to thrive, hepatomegaly, mild hypoglycemia, marked evlevation of liver enzymes, mild lactic acidosis

muscle weakness, cardiomyopathy, cirrhosis, hepatocellular carcinoma

avoid prolonged fasting, use of starch, and high-protein diet

Front 18

GSD6/9

Back 18

impaired hepatic phosphorylase activity

short stature, mild hepatomegaly, and mild hypoglycemia

muscle weakness, cardiomyopathy, cirrhosis

avoid prolonged fasting, use of corn starch

Front 19

hereditary fructose intolerance

Back 19

increased fructose1phosphate accumulates in cells of GI and hepatocytes because can't use it

vomiting, diarrhea, abdomen pain, hypoglycemia

avoid fructose

Front 20

gluconeogenic disorders

Back 20

cause hypoglycemia after initial stages of fasting are complete and glycogen is used up

Front 21

fatty acid oxidation disorder

Back 21

presents later than glycogenolysis or gluconeogenesis disorders

present in infants and children at an older age

hypoglycema + skeletal and cardiac problems

see ketotic hypoglycemia and kiver failure, hepatic encephalopathy, hypotonia

restrict fat, eat a high carb diet

Front 22

hypopituitarism

Back 22

causes hypoglycemia

decreased ACTH or GH

Front 23

idiopathic ketotic hypoglycemia

Back 23

children are unable to tolderate prolonged periods of fasting

see toddlers with hypoglycemia and ketonemia

will out grow

Front 24

aquired hyerinsulinism

Back 24

at age 2-3 usually insulinoma

does not resond to glucose or diaxozide

PET scan