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5 Written questions

5 Multiple choice questions

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

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. 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. alcohol induced hypoglycemiafrom 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. glucagonomaoccur as result of tumors of α-cells of islet of Langerhans, excessive secretion of glucagon-->secondary diabetes

          

  5. 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