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Test 8: Glucose control and hypoglycaemia

  1. Glucose is stored in the body as glycogen in:
    • The brain
    • The red blood cells
    • The liver
    • Fat
  2. In the healthy newborn infant the blood glucose concentration is:
    • Lower than a normal adult
    • The same as a normal adult
    • Higher than a normal adult
    • Higher than a normal child
  3. The normal blood glucose concentration in a newborn infant is:
    • Less than 2.5 mmol/l
    • 2.5 mmol/l to 7.0 mmol/l
    • 1.4 mmol/l to 10.0 mmol/l
    • 7.0 mmol/l to 15 mmol/l
  4. The definition of severe hypoglycaemia is a blood glucose concentration:
    • Less than 7.0 mmol/l
    • Less than 5.0 mmol/l
    • Less than 2.5 mmol/l
    • Less than 1.4 mmol/l
  5. Hypoglycaemia is dangerous as it may cause:
    • Jaundice
    • Brain damage
    • Anaemia
    • Bleeding
  6. Which of the following problems is likely to cause hypoglycaemia because the infant has an increased breakdown of glucose?
    • A skin temperature below 36°C
    • An intraventricular haemorrhage
    • Jaundice
    • Bruising
  7. The following infants are at high risk of hypoglycaemia as they have increased energy (glucose) requirements:
    • Infants with recurrent apnoea
    • Infants born after 37 weeks gestation
    • Infants with respiratory distress
    • Infants with jaundice
  8. Infants born to diabetic women are at risk of hypoglycaemia because they commonly have:
    • Increased secretion of insulin
    • Decreased secretion of insulin
    • No secretion of insulin
    • No pancreas
  9. The following infants are at an increased risk of hypoglycaemia:
    • Female infants
    • Male infants
    • Wasted infants
    • Term infants
  10. Hypoglycaemia:
    • Always presents with clinical signs.
    • Never presents with clinical signs.
    • May present with clinical signs.
    • Usually kills the infant.
  11. Hypoglycaemia may present with:
    • Jaundice
    • Convulsions
    • Pyrexia
    • Oedema
  12. What should be given as the first feed to a healthy, preterm infant of 1850g?
    • Sterile water
    • A milk feed
    • A 5% glucose feed
    • A 50% glucose feed
  13. To prevent hypoglycaemia you should routinely start feeding term infants:
    • Immediately after delivery
    • At 1 hour after delivery
    • At 3 hours after delivery
    • At 6 hours after delivery
  14. If a newborn infant had severe hypoglycaemia in a rural clinic with very limited facilities, which form of treatment should you give?
    • Give a feed of 50% dextrose.
    • Give a feed of cow’s milk and sugar if the mother has no breast milk.
    • Not feed the infant but send the mother and infant to the nearest hospital for an intravenous infusion.
    • Advise the mother to take the infant home.
  15. Severe hypoglycaemia in a preterm infant is best treated by:
    • Feeding the infant with breast milk
    • Giving 5% dextrose by nasogastric tube
    • Giving an intravenous bolus of 25% dextrose
    • Starting an intravenous infusion of 10% dextrose
  16. In hospital you are unable to find a suitable vein to start an intravenous infusion in a 4000?g infant of a diabetic woman. The infant has severe hypoglycaemia. Would you:
    • Pass an umbilical vein catheter and start a 10% dextrose solution?
    • Give a 5% dextrose feed?
    • Cool the infant to conserve energy?
    • Start antibiotics?
  17. If an infant develops severe hypoglycaemia you should:
    • Repeat the blood glucose measurement in 30 minutes to assess whether it has improved.
    • Treat the hypoglycaemia immediately.
    • Refer the infant to the nearest newborn intensive care (level 3) unit.
    • Try to contact a more senior staff member to treat the infant.
  18. In an infant being treated for severe hypoglycaemia, when should regular blood glucose concentration measurements with reagent strips be stopped?
    • Once the intravenous dextrose infusion is started
    • As soon as the blood glucose concentration returns to normal
    • Only after 5 days
    • When the infant has been weaned from intravenous dextrose to milk feeds
  19. A very high blood glucose concentration:
    • Helps the infant to grow rapidly.
    • Causes glycosuria which may result in the infant becoming dehydrated.
    • Is common in newborn infants of diabetic mothers.
    • Is caused by feeding the infant too frequently.
  20. Hyperglycaemia as a complication of an intravenous infusion of 10% dextrose or Neonatalyte is usually seen in:
    • Wasted infants
    • Preterm infants
    • Postterm infants
    • Infected infants