Questions to prepare for classes and examination
• Typical forms of derangement of carbohydrate metabolism.
• Hypoglycemia: definition, metabolic consequences, adaptive reaction of the endocrine system.
• Symptoms of hypoglycemia:
— derived from autonomic response;
— derived from neuroglycopenia.
• Causes of hypoglycemia.
• Hypoglycemic encephalopathy and coma.
• Glycogenoses: classification, manifestations, mechanisms of pathology.
• Aglycogenoses.
• Hexosemias. Galactosemia: manifestation and mechanisms of pathology.
• Pentosemias. Fructose intolerance: manifestations and mechanisms of pathology.
• Hyperglycemia: causes and mechanisms.
• Diabetes mellitus: characteristic features, classification, pathogenesis of type I and type II forms.
• Metabolic disorders (carbohydrate, protein, lipid) in diabetes mellitus.
• Complications of diabetes mellitus. Ketoacidotic and hyperosmolar coma.
N 49
A 60-year-old patient M. was admitted to hospital in an unconscious state. On examination: the skin appears dry, turgor of the skin and eye ball is reduced; shallow breathing; heart rate 96 beats/min; the tongue is dry; recurrent cramps of the extremities and face muscles. Blood tests show hyperglycemia (600 mg glucose per dl), hyperazotemia, hypernatremia, pH 7.32.
The relative who accompanied the patient to hospital told the physician that the patient had been suffering from diabetes mellitus and had ingested small doses of hypoglycemic medicines. During the last month he experienced exacerbation of chronic cholecystitis and colitis, suffered from vomiting and diarrhea which occurred quite often. The patient also felt constantly thirsty and frequently urinated.