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5 Written questions

5 Multiple choice questions

  1. consumption of large quantities of alcohol after fasting or being malnourished-->risk of becoming hypoglycaemic

    large quantities of alcohol produce large amount of NADH-->favor lactate formation rather than gluconeogenesis
  2. formed when proinsulin is converted into insulin in pancreas, essential for proper folding of insulin, has a longer t1/2 than insulin (6min)-->elevated serum levels accompanies hyperinsulinism
  3. from accidental or intentional use of hypoglycaemic agents (sulphonylureas / insulin injections)

    diagnose by measuring patient's serum levels of insulin, C-peptide and proinsulin at time of showing symptoms

    show high serum insulin, low C-peptide, low proinsulin levels
  4. tumor in region of β-cells of islets of Langerhans, associated with excessive insulin production and secretion, mostly benign solitary lesions,usually found in tail of pancreas, treatment by surgery wherever possible
  5. result of effects of epinephrine (palpitations, tremors, sweating), usually occur following sudden drop in blood glucose levels--catecholamine surge

5 True/False questions

  1. high serum insulin, high C-peptide, high proinsulin levels without sulphonylureaindicative of insulinoma

          

  2. reactive hypoglycemiamay be caused by drug-induced hypoglycaemia or postprandial hypoglycaemia (within 5h of meal), some individuals manifest transitory hypoglycaemic symptoms after eating a large carbohydrate meal--causes exaggerated transient insulin response, does not usually indicate underlying disorder

          

  3. Whipple's Triadfor diagnosis of hypoglycemia
    1. adrenergic /neuroglycopenic symptoms
    2. blood glucose <50mg/dL at time of symptoms
    3. improvement of symptoms on ingestion of glucose

          

  4. fasting hypoglycemiamay be caused by drug-induced hypoglycaemia or postprandial hypoglycaemia (within 5h of meal), some individuals manifest transitory hypoglycaemic symptoms after eating a large carbohydrate meal--causes exaggerated transient insulin response, does not usually indicate underlying disorder

          

  5. neuroglycopenic symptoms of hypoglycemiamediated by impaired supply of glucose to brain over extended period of time, following gradual decline in blood glucose concentration, does not elicit epinephrine response, brain cell malfunction when deprived of glucose, cognitive behavior affected, have slurred speech, confusion, seizures, may have coma leading to death if not corrected, slow decline in blood glucose level without sudden release of epinephrine

          

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