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PSBEDM Review > 34 Pathophysiology of Type 2 Diabetes Mellitus > Flashcards

34 Pathophysiology of Type 2 Diabetes Mellitus Flashcards

1
Q

Primary site for de novo lipogenesis

A

Liver

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2
Q

Primary storage for triglycerides

A

Adipose tissue

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3
Q

Main effects of insulin signaling in the muscle (3)

A

Glucose uptake/metabolism
Protein synthesis/growth
Suppression of atrophy/autophagy

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4
Q

Main effects of insulin signaling in adipose tissue (4)

A

Glucose uptake
Lipogenesis
Gene regulation
Suppression of lipolysis

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5
Q

Main effects of insulin signaling in the liver (2)

A

Lipogenesis
Suppression of glucose production

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6
Q

Predominant glucose transporters in the brain (2)

A

Glut1 and Glut3

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7
Q

Abdominal fat vs subcutaneous fat:
More lipolytically active

A

Abdominal fat

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8
Q

Abdominal fat vs subcutaneous fat:
Greater complement of adrenergic receptors

A

Abdominal fat

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9
Q

Abdominal fat vs subcutaneous fat:
Resistant to antilipolytic effects of insulin

A

Abdominal fat

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10
Q

Abdominal fat vs subcutaneous fat:
Releases more adiponectin

A

Subcutaneous fat

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11
Q

Abdominal fat vs subcutaneous fat:
High levels of HSD11B1

A

Abdominal fat

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12
Q

Abdominal fat vs subcutaneous fat:
Increased local cortisol production

A

Abdominal fat

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13
Q

Predominant insulin receptor isoform in the brain

A

IR-A

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14
Q

Primary site of glucose disposal after a meal

A

Skeletal muscle

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15
Q

Maternal insulin secretion increases by how much in pregancy

A

250%

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16
Q

Mechanism as to how calcineurin inhibitor contributes to diabetes

A

Decreased insulin secretion

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17
Q

Most common adverse effect of bromocriptine use in diabetes

A

Nausea

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18
Q

Onset of action of rapid acting insulins

A

<5 mins: Aspart (Fiasp)
10-20 mins: Aspart (Novolog), Lispro (Humalog), Glulisine (Apidra)

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19
Q

Time to peak of rapid acting insulins

A

0.5-1.5 hours

20
Q

Duration of action of rapid acting insulins

A

3-5 hours

21
Q

Onset of action of regular human insulin

A

30-45 mins

22
Q

Onset of action of NPH insulin and long acting insulins

A

60-120 mins

23
Q

Time to peak of regular human insulin

A

2-4 hours

24
Q

Duration of action of regular human insulin

A

4-8 hours

25
Q

Time to peak of NPH insulin

A

4-8 hours

26
Q

Duration of action of NPH insulin

A

12-20 hours

27
Q

Three cardinal abnormalities in T2DM

A

Resistance to action of insulin in peripheral tissues
Defective insulin secretion
Increased glucose production by the liver

28
Q

Earliest detectable abnormality in those predisposed to T2DM

A

Insulin resistance

29
Q

This monogenic form of diabetes is characterized by the presence of insulin resistance, acanthosis nigricans, and hyperandrogenism

A

Type A insulin resistance

30
Q

This monogenic form of diabetes is characterized by severe intrauterine growth restriction, abnormal facies, and death within 1-2 years of life

A

Donohue syndrome (leprechaunism)

31
Q

This monogenic form of diabetes is associated with short stature, protuberant abdomen, and abnormalities of teeth and nails. Pineal hyperplasia was a characteristic in the original description of this syndrome.

A

Rabson-Mendenhall syndrome

32
Q

Mutation in the lamin A gene can cause a face-sparing familial partial lipodystrophy, also commonly referred to as:

A

Dunningan syndrome

33
Q

Mutation in the lamin A gene can cause this syndrome characterized by partial lipodystrophy, postnatal growth retardation, and craniofacial and skeletal malformations.

A

Mandibuloacral dysplasia syndrome

34
Q

Acquired generalized lipodystrophy is also known as:

A

Seip-Lawrence syndrome

35
Q

First polymorphism identified for T2DM

A

Gly972Arg in IRS1

36
Q

Mutations in these genes are thr most common cause of neonatal diabetes

A

KCNJ11 and ABCC8

37
Q

A variant in this gene found almost exclusively in the Samoan population is associated with a large increase in BMI per risk allele and is also associated with a paradoxical decrease in risk of developing T2DM

A

CREBRR

38
Q

Main glucose transporter involved in uptake in muscle and dipose

A

GLUT4

39
Q

Effect of insulin action on the endothelium

A

Vasodilation

40
Q

Effect of insulin stimulation on cardiomyocyte (2)

A

Increased glucose oxidation and hypertrophy
Suppressed fatty acid oxidation and autophagy

41
Q

Primary site of glucose disposal after a meal

A

Skeletal muscle

42
Q

Primary deacetylase of mitochondria

A

Sirt3

43
Q

Enzyme that catalyzes the transfer of acyl chain from carnitine to CoA

A

CPT2

44
Q

Enzyme that mediates the uncoupling of oxidative phosphorylation in brown adipose tissue for thermogenesis

A

UCP1

45
Q

Lipoatrophy in HIV is primarily associated with the use of:

A

Older thymidine analogue NRTIs

PSBEDM Review (20 decks)

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