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hypoglycemia hypotonia, vomiting, diarrhea, hepatomegaly, jaundice…

- - - - acylcarnitine level?
        
        low
        
        primary carnitine deficiency
        
        low carnitine
        
        musle weakness, cardiomyopathy
        
        high
        
        MCAD
        
        impaired beta ox
        
        dicarboxylic acid
  - - - Not hypogly
        
        pompei
        
        cardiomegaly
        
        PomPe trashes PumP (a1,4 glucodisease def) heart, liver, muscle
        
        McArdle
      - lactic acidois?
        
        fasting (hrs after eating)
        
        yes: Von Gierke
        
        severe hypogly
        
        gout
        
        No: Cori
        
        intact gluconeogenesis
        
        mild hypogly
    - - Weaned off breask milk?
        
        lactic acidosis
        
        post prandial
        
        FAB GUT
        
        yes: hereditary fructose intolerance
        
        fructose (not in breast milk
        
        Aldolase B deficiency
        
        no: Galactosemia
        
        galactose 1p UT deficiency (GALT)
        
        breast milk: lactose-> galactose+glucose
        
        galacitol (cataract), intellectual disability