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5 Written questions

5 Multiple choice questions

  1. 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
  2. releases insulin-like protein that causes hypoglycaemia
  3. for 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. result of effects of epinephrine (palpitations, tremors, sweating), usually occur following sudden drop in blood glucose levels--catecholamine surge
  5. 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

5 True/False questions

  1. insulinomatumor 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


  2. factitious hypoglycaemiausually occurs 6-7 hours after last meal, indicative of underlying disorder, most patients are Type 1 diabetics receiving too large dose of insulin, may be caused by liver disease (more than 80% of liver damage can severely compromise hepatic gluconeogenesis), can be caused by Addison's disease--hyposecretion of cortisol rendering tissues more sensitive to insulin


  3. hypoglycemiacondition where blood glucose level is less than 2.5mmol/L (45mg/dL), symptom of underlying disease, can develop as result of liver diease, hormonal disorder, genetic disorcer, GI tract surgery

    body responds to falling blood glucose levels by stimulating sympathteic nervous system-->induces secretino of epinephrine, cortisol, glucagon-->have collective antagonistic effect on insulin secretion

    first organ to be affected is brain

    symptoms include confusion, dizziness, shaky feelling, hunger, headaches, irritability, pounding heart, racing pulse, pale skin, sweating, trembling, weakness, anxiety

    two division of symptoms: adrenergic and neuroglycopenic

    two regulator mechanisms: pancreatic secretion of glucagon, hypothalamus glucoreceptors

    classified as either reactive hypoglycemia or true organic fasting hypoglycemia

    occurs in insulin-dependent diabetics usually as a result of excess insulin or sulphonylurea administration, strenuous exercise, insufficient carbohydrate ingestion, excess alcohol ingestion


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


  5. high serum insulin, high C-peptide, high proinsulin levels with sulphonylureaindicative of reactive hypoglycaemia, sulphonylurea overdose--promote pancreatic secretion of insulin