Endocrine Drugs and Medications Q 24

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Signs of hypoglycemia include:

  

     A. Fruity breath, thirst, flushed skin

     B. Diarrhea, itching, hypertension

     C. Anxiety, weakness, pallor, sweating

     D. Muscle ache, fever, thirst

    

    

Correct Answer: C. Anxiety, weakness, pallor, sweating

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These are signs of hypoglycemia, along with restlessness, chills, confusion, nausea, hunger, tachycardia, weakness, or headache. Neurogenic signs and symptoms can either be adrenergic (tremor, palpitations, anxiety) or cholinergic (hunger, diaphoresis, paresthesias). Neurogenic symptoms and signs arise from sympathoadrenal involvement (either norepinephrine or acetylcholine release) in response to perceived hypoglycemia.

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Option A: These are signs of hyperglycemia. Symptoms of severe hyperglycemia include polyuria, polydipsia, and weight loss. As the patient’s blood glucose increases, neurologic symptoms can develop. The patient may experience lethargy, focal neurologic deficits, or altered mental status. The patient can progress to a comatose state.

Option B: Neuroglycopenic signs and symptoms are signs and symptoms that result from direct central nervous system (CNS) deprivation of glucose. These include behavioral changes, confusion, fatigue, seizure, coma, and potential death if not immediately corrected.

Option D: Patients who have diabetes can present with symptoms of hypoglycemia at relatively higher serum glucose levels. The chronic hyperglycemia alters the “set point” in which neuroglycopenic/neurogenic symptoms become apparent. This phenomenon is referred to as “pseudohypoglycemia” because the serum glucose may be within normal range despite symptom presentation.

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