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5 Written questions

5 Multiple choice questions

  1. mediated 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
  2. occur as result of tumors of α-cells of islet of Langerhans, excessive secretion of glucagon-->secondary diabetes
  3. condition 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. indicative of insulin overdose, accidental or deliberate
  5. indicative of insulinoma

5 True/False questions

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


  2. adrenergic symptoms of hypoglycemiaresult of effects of epinephrine (palpitations, tremors, sweating), usually occur following sudden drop in blood glucose levels--catecholamine surge


  3. alcohol induced hypoglycemiaconsumption 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


  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. 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