Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > 184/185. Diabetes > Flashcards

184/185. Diabetes Flashcards

1
Q

ROS generation results in DNA strand breaks with activation of __

__ activation results in inactivation of GAPDH
- furthers ROS production by mitochondria and shunting of glucose and glycolytic intermediates into pathways mediating diabetic complications (polyol, PKC, AGE, glucosamine)

A

PARP (ADP ribose polymerase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Not absolutely dependent upon exogenous insulin

Not prone to ketoacidosis

Often obese

Historically was typically diagnosed after the age of 40 yo
- recognized with increasing frequency in children d/t childhood obesity

Strong family history

A

Type 2 DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

__ will decrease w/ time as islet cells are destroyed due to lack of antigen

A

Islet cell antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vast majority of genes associated with Type 2 DM affect __ function
- as opposed to insulin resistance

Leads to glucotoxicity, lipotoxicity, ER stress, mitochondrial dysfunction, oxidative stress, islet inflammation, increase islet amyloid polypeptides

A

Beta-cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Microvascular complication of diabetes that is the leading cause of adult renal failure

A

Nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Autoantibodies to the zinc transporter which transports zinc into insulin granules (expressed in beta cells)

Present in 60-80% at diagnosis of type 1 DM

A

ZnT8 autoantibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the key electrolyte to focus on when treating diabetic ketoacidosis?

Will need to add __ supplements to fluid when it enters normal range

A

K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hyperglycemia-induced complication

Increased intracellular glucose results in increase __ formation and protein glycation

  • __s damage target cells by 3 mechanisms:
    1. function of __-modified proteins may be altered
    2. components of the ECM modified by __s may interact abnormally with other matrix components and/or integrins
    3. plasma proteins modified by __ precursors are able to bind to a receptor for __s which results in the generation of ROS

There is an increase of their receptors

A

AGE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Patients with Type 1 diabetes who are treated with insulin are at a higher risk of __ than type 2 diabetics

A

Hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute effect of insulin deficiency:

  1. In absence of insulin proteolysis and breakdown of __ occur
  2. __ output increases secondary to glucogenolysis and gluconeogenesis
  3. __ are metabolized into ketoacids which decreases plasma pH
  4. __ occurs secondary increased hepatic glucose and decreased peripheral uptake of glucose
  5. Hyperglycemia causes __ with resulting dehydration and loss of electrolytes in urine
A
  1. TGs
  2. Hepatic
  3. Free fatty acids
  4. Hyperglycemia
  5. Glucosuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complex metabolic disorder
- multiple factors contribute

Defined as decreased ability of insulin to lower circulating glucose concentrations

  • impaired stimulation of glucose utilization by muscle and fat
  • impaired suppression of glucose production by liver
A

Insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fasting plasma glucose more than 100 but less than 125

A

Impaired fasting glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

3 most common microvascular complications to worry about in diabetic patients

A

Retinopathy
Nephropathy
Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The combination product of hemoglobin A and glucose (glycation)

Reflects the average levels of glucose in the blood for the previous several months and therefore indicates the degree of diabetic control

A

HgbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Leading cause of death among pts with diabetes

A

Ischemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of type 1 diabetes?

Due to glucose spilling into urine and water following

Due to not incorporating calories into tissues

A

Polyuria (95%)
Weight loss (60%)
Fatigue (50%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diabetes is a chronic metabolic disorder that impacts the metabolism of what 3 types of energy sources?

A

Carbohydrates
Protein
Fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What kind of immune cells are thought to be causative of Type 1 DM?

A

T-cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the peak ages for Type 1 DM diagnosis?

A

10-14yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hyperglycemia-induced complication

High glucose flux through constitutive glucose transporters on the surface of endothelial cells increases intracellular glucose levels and results in the generation of __ by mitochondria

A

ROS

21
Q

Autoantibodies that are present in 40-50% at diagnosis

Presence of this with ICA are highly predictive of diabetes

A

IAA (Insulin autoantibodies)

22
Q

2 hour plasma glucose more than 140 but less than 200

A

Impaired glucose tolerance

23
Q

Microvascular complication of diabetes that is the leading cause of nontraumatic amputations in adults

Presents in a stocking-glove distribution

Can lead to diabetic ulcers

A

Neuropathy

24
Q

Hyperglycemia-induced complication

Activation of ___

  • intracellular hyperglycemia results in increased DAG synthesis with subsequent activation of __
  • increased __ activity has a variety of effects in endothelial and other cell types

Increase __ leads to increase collagen, fibronectin, decrease fibrinolysis, and increased ROS

A

Protein Kinase C

25
Q

What kind of obesity has a major impact on underlying insulin sensitivity

A

Central obesity

26
Q

Aspect of lifestyle changes for Type 2 DM pts:

  • decrease fat content and total calories
  • decreased saturated fat
  • decrease salt for hypertension
  • healthy diet
  • weight reduction in obese patients

Used along with moderate-intensity exercise and smoking cessation

A

Nutrition therapy

27
Q

Type 1 diabetes is associated with certain __ types

In particular, DR3 and/or DR4

Some of these genes are unique to Type 1 DM and some also associated with other autoimmune disorders

A

HLA

28
Q

Occurs due to autoimmune destruction of beta cells in pancreatic islets

Insulitis can be seen on histology during the development of this disease

A

Type 1 diabetes

29
Q

Highly associated with insulin resistance

A

Obesity

30
Q

What is the mechanism for hyperkalemia occurring diabetic ketoacidosis?

A

Increased H+/K+ transporter therapy moving H+ into cells and K+ into ECF

31
Q

Accounts for 5-10% of diabetes worldwide

Insulinopenic

  • dependent on exogenous insulin for life
  • ketosis prone under basal conditions
A

Type 1 diabetes

32
Q

Absence of __ phase insulin release is common in type 2 DM

This causes hyperglycemia to ensue

A

first

33
Q

Antibodies that are present in 70-80% at diagnosis of type 1 DM

Persist longer than ICA

A

GADA (glutamic acid decarboxylase autoantibodies)

34
Q

Fasting plasma glucose < 100

2 hour plasma glucose < 140

A

Normal

35
Q

Fasting plasma glucose more than 125 and 2 hour plasma glucose more than 200

A

Diabetes

36
Q

HLA locus demonstrates strong associated with type 1 DM

There is a significant effect of insulin and __ genes as well

A

PTPN22

37
Q

Markers of autoimmunity useful for predicting disease and diagnosing disease when presentation is not classic for type 1 DM

A

Islet cell antibodies

38
Q

Antibodies to the transmembrane protein tyrosine phosphatase

Present in about 60% of individuals at diagnosis

A

IA2A (Insulinoma associated 2 autoantibodies)

39
Q

Hyperglycemia with a secondary decrease in plasma pH due to increased production of ketoacids is referred to as

A

Diabetic ketoacidosis

40
Q

Adipose tissue inflammation is due to __ which interfere with insulin signaling
- along with lipid metabolites

A

Cytokines

41
Q

Islet cell antibodies present years to months before onset of clinical type 1 DM

Those with __ or more autoantibodies are at highest risk for progressing to type 1 diabetes

A

2

42
Q

Obesity =>

  • skeletal muscle: increased FFA uptake, increased extramyocellular adipose, macrophage activation/recruitment, ER stress
  • Adipose: Adipocyte hypertrophy, macrophage recruitment, macrophage polarity switch, increased cytokine production, increased lipolysis, ER stress
  • Liver: increased lipid content, steatosis, kupffer cell activation/recruitment, increased cytokine production, ER stress

Thus, obesity leads to insulin resistance and __

A

Inflammation

43
Q

People with type 2 DM don’t increase insulin secretion in response to hyperglycemia due to decrease __
- central obesity has a major impact

Decreased beta-cell compensation for the insulin resistance

A

Insulin sensitivity

44
Q

Detected by incubating patient serum with pancreatic sections

75-80% of caucasian children are positive for this antibody at the time of type 1 DM diagnsosis

A

ICA (islet cell autoantibodies)

45
Q

Hyperglycemia-induced complication

Increased flux of glucose and other sugars through the polyol pathway

  • hyperglycemia is associated with increased intracellular glucose in insulin-unresponsive tissues which results in the conversion of glucose to the polyol __ by aldose reductase
  • this reaction consumes NADPH which is required for regenerating reduced glutathione
  • as reduced glutathione is depleted oxidative stress is induced or exacerbated
A

Sorbitol

46
Q

Diabetic ketoacidosis treatment includes 2 separate treatments

A
  1. IV insulin therapy

2. IV saline (.9 first then alternating .9 and .45 after fluids are restored)

47
Q

Microvascular complication of diabetes that is the leading cause of adult blindness

A

Retinopathy

48
Q

__ is exacerbated by obesity, sedentary lifestyle, age, and some medications (steroids)

A

Insulin resistance

Endocrine (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions