Hypoglycaemia in Infants and Children – 18 Board-Style Questions

What this deck covers

Hypoglycaemia in Infants and Children in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. The one chance to find out why
2. Which newborns get checked
3. Both fuels switched off at once
4. The first drug to reach for
5. A slim toddler after a bug
6. Fasting with nothing to show for it
7. A huge liver and a short fuse
8. Clues in the middle of the face
9. Dark skin and the wrong salts
10. A sick jaundiced newborn
11. Found at the grandparents’ house
12. The peptide that tells them apart
13. Grandfather’s heart tablets
14. Two low readings, different reasons
15. Fitting and needing sugar now
16. A borderline value on the ward
17. A plan for the next illness
18. A big baby with an odd ear

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Give the sugar and send the samples an hour later, Every baby on the postnatal ward, Ketotic hypoglycaemia of childhood, Diazoxide with a thiazide diuretic, Congenital hyperinsulinism, A defect of fatty acid oxidation, A urea cycle disorder, Hypopituitarism, Primary adrenal insufficiency, Alpha one antitrypsin deficiency, Sulfonylurea ingestion, Congenital hyperinsulinism of infancy, Beta blocker ingestion, Too much insulin from the pancreas.

Clinical pearls from this deck

• Samples first, sugar second. Seconds of delay buy a diagnosis that is otherwise lost.
• Screen the at-risk baby, not every baby, and never wait for a symptom.
• Insulin should be invisible when the sugar is low. If you can measure it, that is the answer.
• Diazoxide first, always with a thiazide, and never a pancreas until the imaging is done.
• High ketones during the low is reassuring: the machinery is working, the fuel simply ran out.
• No ketones during a fast is never normal. Send an acylcarnitine profile the same day.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Endocrinology Board Questions case decks · pediatric reference values.