[MCQ] Hypoglycemia- Part 1

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Hypoglycemia- Part 1

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Congratulations - you have completed Hypoglycemia- Part 1. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

For diagnosis of hypoglycemia, Whipple’s triad consists of all except ?

A	History of diabetes mellitus
B	Hypoglycemic symptoms
C	Low plasma glucose level
D	Relief of symptoms after plasma glucose level is raised

Question 1 Explanation:

Whipple’s triad for diagnosis of hypoglycemia includes symptoms consistent with hypoglycemia, low plasma glucose concentration and relief of symptoms after plasma glucose level is raised

Question 2

Hepatic glycogen stores are sufficient to maintain plasma glucose levels for ?

A	4 to 6 hours
B	8 to 12 hours
C	24 to 48 hours
D	72 to 96 hours

Question 2 Explanation:

Hepatic glycogen stores are sufficient to maintain plasma glucose levels for 8 to 12 hours.

Question 3

Precursors required for gluconeogenesis include ?

A	Lactate
B	Pyruvate
C	Acetyl CoA
D	All of the above

Question 3 Explanation:

Muscle provides lactate, pyruvate, alanine. Triglycerides in adipose tissue are broken down into glycerol. Free fatty acids generate acetyl CoA for gluconeogenesis

Question 4

In hypoglycemia, which of the following is the first physiologic response to falling plasma glucose levels ?

A	Decreased Insulin
B	Increased Glucagon
C	Increased Epinephrine
D	Increased Cortisol

Question 5

Neuroglycopenic symptoms of hypoglycemia include all except ?

A	Fatigue
B	Hunger
C	Seizure
D	Loss of consciousness

Question 5 Explanation:

Neuroglycopenic symptoms are a direct result of CNS neuronal glucose deprivation that include behavioral changes, confusion, fatigue, seizure, loss of consciousness. Hypoglycemia-induced autonomic responses include adrenergic symptoms like palpitations, tremor, and anxiety while cholinergic symptoms are sweating, hunger, and paresthesia.

Question 6

Hypoglycemia following alcohol ingestion is due to ?

A	Insulin sensitivity is increased
B	Influx of exogenous glucose is reduced
C	Endogenous glucose production is reduced
D	Insulin clearance is reduced

Question 6 Explanation:

Endogenous glucose production is reduced following alcohol ingestion. Ethanol blocks gluconeogenesis but not glycogenolysis.

Question 7

GLUT is best described as a ?

A	Transmembrane protein
B	Nuclear protein
C	Cytoplasmic protein
D	Mitochondrial protein

Question 7 Explanation:

Group of glucose transporters (GLUT) consists of five homologous trans-membrane proteins, GLUT-1, 2, 3, 4, and 5 that are encoded by distinct genes.

Question 8

Which of the following GLUT is an insulin-responsive glucose transporter ?

A	GLUT-1
B	GLUT-2
C	GLUT-3
D	GLUT-4

Question 8 Explanation:

GLUT-4 is the main insulin-responsive glucose transporter, located primarily in muscle cells & adipocytes

Question 9

Which of the following GLUT is a fructose transporter ?

A	GLUT-2
B	GLUT-3
C	GLUT-4
D	GLUT-5

Question 9 Explanation:

GLUT-5 is distributed in small intestine, sperm, kidney, brain, adipose cells and muscle. It is characteristically a fructose transporter and has a very low affinity for glucose

Question 10

Which of the following GLUT is found in placenta ?

A	GLUT-1
B	GLUT-2
C	GLUT-3
D	GLUT-4

Question 10 Explanation:

GLUT-3 is distributed in neurons and placenta. It is a high-affinity glucose transporter

Question 11

Blood-to-brain glucose transport is facilitated by ?

A	GLUT-1
B	GLUT-2
C	GLUT-3
D	GLUT-4

Question 11 Explanation:

Mutations in GLUT-1 are associated with intractable seizures resulting from a reduction in glucose transport across the blood–brain barrier.

Question 12

Fanconi - Bickel syndrome is caused by mutations in which of the following glucose transporters ?

A	GLUT-1
B	GLUT-2
C	GLUT-3
D	GLUT-4

Question 12 Explanation:

GLUT-2 mutations cause the rare, autosomal recessive Fanconi - Bickel syndrome characterized by hepatic & renal glycogen accumulation, nephropathy & impaired utilization of glucose & galactose.

Question 13

Falling arterial glucose concentrations are sensed by ?

A	Brain
B	Hepatic portal vein
C	Carotid body
D	All of the above

Question 14

Which of the following is true about syndrome of hypoglycemia unawareness ?

A	Attenuated sympathetic neural response
B	Attenuated adrenomedullary response
C	Loss of neurogenic warning symptoms
D	All of the above

Question 14 Explanation:

Periods of relative or absolute therapeutic insulin excess leading to falling glucose concentrations, with absent counterregulatory glucagon responses, reduced autonomic responses, reduced epinephrine responses cause hypoglycemia unawareness

Question 15

Syndrome of hypoglycemia unawareness can be reversed by ?

A	>1 week of scrupulous avoidance of hypoglycemia
B	>1 week of scrupulous avoidance of hyperglycemia
C	>2 weeks of scrupulous avoidance of hypoglycemia
D	>2 weeks of scrupulous avoidance of hyperglycemia

Question 15 Explanation:

Syndrome of hypoglycemia unawareness can be reversed by >2 weeks of scrupulous avoidance of hypoglycemia.

Question 16

Which of the following statements about postprandial (reactive) hypoglycemia is false ?

A	Occurs only after meals
B	Self-limited
C	Alimentary hypoglycemia
D	None of the above

Question 16 Explanation:

Postprandial (reactive) hypoglycemia occurs only after meals and is self-limited. Causes include enzymatic defects in carbohydrate metabolism like hereditary fructose intolerance and galactosemia, post gastric surgery (alimentary hypoglycemia).

Question 17

Which of the following might help in the treatment of postprandial (reactive) hypoglycemia ?

A	Metformin
B	Alpha-glucosidase inhibitor
C	Glucagon
D	All of the above

Question 17 Explanation:

Alpha-glucosidase inhibitor delays carbohydrate digestion and glucose absorption from intestine and may be useful in reactive hypoglycemia

Question 18

Which of the following is a cause of fasting hypoglycemia ?

A	Ethanol use
B	Sepsis
C	Renal failure
D	All of the above

Question 18 Explanation:

Apart from insulin and sulfonylureas, ethanol use, sepsis and renal failure are causes of fasting hypoglycemia. In sepsis, endogenous glucose production is impaired due to hepatic hypoperfusion, and cytokine induced glucose utilization is increased.

Question 19

Fasting hypoglycemia occurs with which of the following ?

A	Hepatoma
B	Adrenocortical tumors
C	Carcinoids
D	All of the above

Question 19 Explanation:

Hepatoma, adrenocortical tumors and carcinoids can cause fasting hypoglycemia due to overproduction of insulin-like growth factor (IGF) II that through insulin or IGF-I receptors

Question 20

Somogyi effect is best understood as ?

A	Post hyperglycemic hypoglycemia
B	Post hypoglycemic hyperglycemia
C	Nocturnal hypoglycemia
D	All of the above

Question 21

Use of which of the following drugs can cause hypoglycemia ?

A	Pentamidine
B	Quinine
C	Salicylates
D	All of the above

Question 21 Explanation:

Pentamidine is toxic to the pancreatic beta cell. Initially it causes insulin release with hypoglycemia, and later predisposes to diabetes mellitus. Quinine stimulates insulin secretion. Salicylates and sulfonamides can cause hypoglycemia.

Question 22

Endogenous hyperinsulinism is diagnosed by ?

A	Fasting plasma insulin >= 6 μU/mL
B	Fasting plasma C-peptide >= 0.6 ng/mL
C	Fasting plasma glucose <= 45 mg/dL
D	All of the above

Question 22 Explanation:

Despite of hypoglycemia, plasma insulin & C-peptide levels are high in endogenous hyperinsulinism

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See all quizzes of Diabetes Mellitus at here:

1. For diagnosis of hypoglycemia, Whipple’s triad consists of all
except ?
A. History of diabetes mellitus
B. Hypoglycemic symptoms
C. Low plasma glucose level
D. Relief of symptoms after plasma glucose level is raised

2. Hepatic glycogen stores are sufficient to maintain plasma glucose
levels for ?
A. 4 to 6 hours
B. 8 to 12 hours
C. 24 to 48 hours
D. 72 to 96 hours

3. Precursors required for gluconeogenesis include ?
A. Lactate
B. Pyruvate
C. Acetyl CoA
D. All of the above

4. In hypoglycemia, which of the following is the first physiologic
response to falling plasma glucose levels ?
A. Decreased Insulin
B. Increased Glucagon
C. Increased Epinephrine
D. Increased Cortisol
5. Neuroglycopenic symptoms of hypoglycemia include all except ?
A. Fatigue
B. Hunger
C. Seizure
D. Loss of consciousness

6. Hypoglycemia following alcohol ingestion is due to ?
A. Insulin sensitivity is increased
B. Influx of exogenous glucose is reduced
C. Endogenous glucose production is reduced
D. Insulin clearance is reduced

7. GLUT is best described as a ?
A. Transmembrane protein
B. Nuclear protein
C. Cytoplasmic protein
D. Mitochondrial protein

8. Which of the following GLUT is an insulin-responsive glucose
transporter ?
A. GLUT-1
B. GLUT-2
C. GLUT-3
D. GLUT-4

9. Which of the following GLUT is a fructose transporter ?
A. GLUT-2
B. GLUT-3
C. GLUT-4
D. GLUT-5

10. Which of the following GLUT is found in placenta ?
A. GLUT-1
B. GLUT-2
C. GLUT-3
D. GLUT-4

11. Blood-to-brain glucose transport is facilitated by ?
A. GLUT-1
B. GLUT-2
C. GLUT-3
D. GLUT-4

12. Fanconi – Bickel syndrome is caused by mutations in which of the
following glucose transporters ?
A. GLUT-1
B. GLUT-2
C. GLUT-3
D. GLUT-4

13. Falling arterial glucose concentrations are sensed by ?
A. Brain
B. Hepatic portal vein
C. Carotid body
D. All of the above
14. Which of the following is true about syndrome of hypoglycemia
unawareness ?
A. Attenuated sympathetic neural response
B. Attenuated adrenomedullary response
C. Loss of neurogenic warning symptoms
D. All of the above

15. Syndrome of hypoglycemia unawareness can be reversed by ?
A. >1 week of scrupulous avoidance of hypoglycemia
B. >1 week of scrupulous avoidance of hyperglycemia
C. >2 weeks of scrupulous avoidance of hypoglycemia
D. >2 weeks of scrupulous avoidance of hyperglycemia

16. Which of the following statements about postprandial (reactive)
hypoglycemia is false ?
A. Occurs only after meals
B. Self-limited
C. Alimentary hypoglycemia
D. None of the above

17. Which of the following might help in the treatment of postprandial
(reactive) hypoglycemia ?
A. Metformin
B. Alpha-glucosidase inhibitor
C. Glucagon
D. All of the above

18. Which of the following is a cause of fasting hypoglycemia ?
A. Ethanol use
B. Sepsis
C. Renal failure
D. All of the above

19. Fasting hypoglycemia occurs with which of the following ?
A. Hepatoma
B. Adrenocortical tumors
C. Carcinoids
D. All of the above

20. Somogyi effect is best understood as ?
A. Post hyperglycemic hypoglycemia
B. Post hypoglycemic hyperglycemia
C. Nocturnal hypoglycemia
D. All of the above
21. Use of which of the following drugs can cause hypoglycemia ?
A. Pentamidine
B. Quinine
C. Salicylates
D. All of the above

22. Endogenous hyperinsulinism is diagnosed by ?
A. Fasting plasma insulin >= 6 μU/mL
B. Fasting plasma C-peptide >= 0.6 ng/mL
C. Fasting plasma glucose <= 45 mg/dL
D. All of the above

Hypoglycemia- Part 1

[MCQ] Hypoglycemia- Part 1

I. Start the exam by click the “Start” button

Hypoglycemia- Part 1

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