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Medical Pathophysiology > 2 Diabetes > Flashcards

2 Diabetes Flashcards

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USMLE® Step 1 flashcards
1
Q

what are the exocrine functions of the pancreas?

A

secretes digestive enzymes such as amylase and lipases

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2
Q

what are the endocrine functions of the pancreas?

A

alpha, beta and delta cells

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3
Q

what do delta cells produce?

A

somatostatin to suppress release of growth hormone

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4
Q

what type of diabetes is insulin dependent?

A

type I

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5
Q

what are the functions of insulin?

A

increase glucose uptake in cells and carry out glycogenesis, increase amino acid uptake and protein synthesis, inhibit gluconeogenesis and glycogenolysis

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6
Q

what are the functions of glucagon?

A

acts on hepatocytes to carry out glycogenolysis, form glucose from amino acids and lactic acid

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7
Q

what is the role of amylin?

A

co-secreted with insulin and decreases gastric emptying to suppress glucagon secretion and glucose production

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8
Q

in which type of diabetes is amylin levels lowest? what does this cause?

A

type I as this gives person no response of satiety after a meal and so can cause obesity

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9
Q

what is type I diabetes?

A

pancreas fails to produce insulin due to loss of beta cells

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10
Q

what is type II diabetes?

A

failure to respond to insulin

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11
Q

how might reduced insulin lead to brain dysfunction?

A

glucose released so higher plasma glucose, higher filtration via the kidneys leading to osmotic diuresis, so higher sodium and water loss, causing a lower plasma volume and BP causing a reduced blood flow to the brain

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12
Q

how might increased plasma ketones cause brain dysfunction?

A

lack of insulin means body burns fat stores generating ketones, leading to plasma acidosis and brain dysfunction

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13
Q

what are the possible treatments of type I?

A

islet cell transplants, partial pancreas transplants, full pancreas transplant

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14
Q

what are the positives of basal and prandial insulin?

A

mimics the physiology of insulin release

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15
Q

what effect does pramlintide have when given with insulin?

A

decreases the rise of glucose following a meal

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16
Q

what makes type II a progressive disease?

A

deterioration of beta cells over time that leads to increased insulin resistance

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17
Q

what are the problems associated with monitoring glucose levels?

A

changes due to exercise, food intake varies, illness/stress uses glucose

18
Q

what is HbA1c?

A

a non-covalent form of haemoglobin caused by glucose

19
Q

what can HbA1c be used to measure?

A

long term glucose levels

20
Q

what is the issues with using HbA1c to monitor glucose?

A

does not show day to day changes, episodes of hyper/hypoglycaemia not shown

21
Q

what causes acute toxicity in hyperglycaemia?

A

a sudden spike in blood glucose

22
Q

what causes chronic toxicity of blood glucose?

A

a continuous rise in hyperglycaemia

23
Q

what do acute and chronic toxicity lead to?

A

tissue sessions and diabetic complications

24
Q

what are the two different types of diabetic complications that may arise with hyperglycaemia?

A

microvascular and macrovascular

25
Q

what are the microvascular diabetic complications?

A

retinopathy, nephropathy and neuropathy

26
Q

what are the microvascular diabetic complications?

A

PVD, myocardial infarction, strokes

27
Q

how can retinopathy occur?

A

micro aneurysms occurring in retinal veins

28
Q

how does nephropathy occur?

A

lesions on the glomeruli impairing kidney function, causing proteins to be lost in urine

29
Q

how can neuropathy occur?

A

branching fibres of neurones are lost

30
Q

what blood pressures are considered as hypertension?

A

systolic above 130 mmHg and diastolic above 80 mmHg

31
Q

what medications can be used to treat hypertension?

A

ACE inhibitors or angiotensin receptor blockers

32
Q

how might lipid levels be affected in diabetics?

A

metabolism of lipids may be altered due to insulin regulating lipid metabolism

33
Q

what should levels of LDL be?

A

below 100 mg/dl

34
Q

what should levels of HDL be?

A

above 50 mg/dl

35
Q

what should triglyceride levels be?

A

below 150 mg/dl

36
Q

when should statins be considered?

A

when someone has overt CV disease, or above 40 and no CV yet other risk factors, or those below 40 but with altered LDL levels

37
Q

what are the CVD risk factors?

A

dyslipidaemia, hypertension, smoking, family history

38
Q

how does lipid build up link to increased albuminuria?

A

lipid build up in vessels increased blood pressure and so caused proteins to be forced out of glomerulus

39
Q

when should nephropathy screening occur in diabetics?

A

annually in type I 5 years after diagnosis, annually in type II

40
Q

how can glomerular filtration rate be assessed?

A

measure serum creatinine

Medical Pathophysiology (16 decks)

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