Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine > 396 DM Class > Flashcards

396 DM Class Flashcards

Chap. 396 Diabetes Mellitus Diagnosis Classification and Pathophysiology

1
Q

Refers to a group of common metabolic disorder that share the phenotype of hyperglycaemi

A

Diabetes mellitus

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

Factors Contributingvl to hyperglycaemia

A

Reduced insulin secretion
Decreased glucose utilisation
Increased glucose production

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

Develops as a result of autoimmunity against insulin producing beta cells, resulting in complete or near total insulin deficiency

A

Diabetes Mellitus type 1

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

Heterogenous group of disorders characterized by variable of insulin resistance, impaired insulin secretion, and increased hepatic glucose production

A

Type 2 diabetes mellitus

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

Subtypes of DM characterized by autosomal dominant inheritance, early onset of hyperglycemia usually less than 25 years of age and impaired insulin secretion

A

Maturity onset diabetes of the young (MODY)

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

Most reliable and convenient test for identifying DM in asymptomatic individuals

A

FPG and HbA1c

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

Incretin hormones that bind specific receptors on the beta cell to stimulate insulin secretion through cyclic AMP production

A

Glucagon like peptide 1 (GLP-1)

Glucose dependent insulintropic peptide (GIP)

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

Mechanism of action of incretins

A

Suppress glucagon production and secretion

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

Site of release of GLP-1

A

Neuroendocrine L cells of the GI tract following food intake and in the alpha cells of the pancreas

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

gestational diabetes mellitus

A

gestational diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is diagnosis if glucose tolerance is diagnosed during the first trimester of pregnancy

A

preexisting pregestation diabetes

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

what is the risk of GDM developing o DM in the next 10-20 yrs

A

35-60%

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

what is the recommended screening for the development of DM in patients with GDM

A

lifelong, every 3 years

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

has the highest incidence of type 1 DM

A

Scandinavia

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

what is the harbinger of type 2 DM

A

impaired glucose tolerance

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

what are the three broad categories of glucose tolerance

A

normal glucose homeostasis, impaired glucose homeostasis, DM

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

what is impaired fasting glucose

A

FPG 5.6-6.9 )100-125 mg/dl

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

what is impaired glucose tolerance

A

plasma glucose level 7.8-11 mmol or 140-199 mg/dL

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

values diagnostic of DM

A

FPG of more than 7 mmol or more than 136 mg/dl, 2hrs after glucose challenge plasma glucose more than 11 or more than 200 mg/dL, HbA1c more than 6.5%

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

random plasma glucose sufficient for diagnosis of DM

A

random plasma glucose more than 11.1 mmol or more than 200 mg/dL with classic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ADA recommendation for screening DM

A

age more than 45 yrs old every 3 yrs or earlier if BMI more than 25 or with additional risk factor for DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

most important regulator of metabolic equilibrium

A

insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

useful marker of insulin secretion and allows discrimination of endogenous and exogenous sources of insulin in the evaluation of hypoglycemia

A

C peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

indicative of beta cell dysfunction

A

proinsulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
key regulator of insulin secretion by the pancreatic beta cell
glucose
26
glucose level that stimulate insulin synthesis
glucose more than 3.9 mmol or 70 mg/dL
27
rate limiting step that controls glucose regulated insulin secretion
glucose phosphorylation by glucokinase
28
what is the secretory profile of insuline
pulsatile hormone release every 10 mins and greater oscillations about 80-150 min
29
Asymptomatic patient with FBS 130 mg/dl. What to do next?
in asymptomatic patients with FBS more than 126 mg/dl (more than 7 mmol); 2HPPG more than 200 mg/dl (11.1 mmol) 75 g OGTT or RBS more than 200 mg/dl with 3Ps is diagnostic of DM; repeat any of the test within 2 weeks for confirmation
30
when to use 75g OGTT
prior FBS 0f 100-125 mg/dl 5.6-6.9 mmol; previous diagnosis of cardiovascular disease; diagnosis of metabolic syndrome
31
prior stroke patient came in for screening for diabetes, what is the best screening test for this patient
75 g OGTT
32
what is the risk for T2DM in patient with GDM
substantial risk in next 10-20 years
33
when does insulin resistance during pregnancy occur
late pregnancy
34
True or false. In patients with GDM, there is development of impaired glucose tolerance during postpartum
False. Reverts to normal
35
True or false. There is increased insulin requirement in pregnancy
True.
36
True or false. All pregnant women should be evaluated at the first prenatal visit for risk for diabetes
True.
37
screening for patient with no risk factors
Weeks 24-28 weeks AOG
38
screening for patients with high risk factors
first prenatal visit (soonest time possible)
39
risk factor for GDM
prior history of GDM, glucosuria, family history of diabetes, first degree relative with T2DM, prior macrosomic baby, age more than 25 yrs old, diagnosis of PCOS, overweight or obese before pregnancy, polyhydramnios in current pregnancy, intake of drugs affecting carbohydrate metabolism
40
preferred screening tests for GDM
75 g OGTT
41
Threshold values by IADPSG. FBS, 1 hour, 2 hour,
FBS more than 92; 1 hr more than 180, 2 hr more than 153
42
tests to detect overt DM in patients with GDM
FBS
43
tests to assess glucose metabolism
75 g OGTT one year postpartum; FBS annually
44
where is insulin secreted
About 50% secreted into the portal vein and degraded by the liver
45
Type of insulin that enters systemic circulation
unextracted insulin
46
what pathways are activated by activation of the insulin receptor signaling pathways
glycogen and protein synthesis, lipogenesis, and gene regulation
47
refers to the time of initial clinical presentation of type 1 DM during which glycemic control is achieved with modest dose of insulin
honeymoon phase
48
halotypes strongly associated with type 1 DM
DQA1*0301, DQB1*0302, DQB1*0201
49
halotypes that seem to provide protection from type 1 DM
DQB1*102, DBQ1*602
50
islet cell types spared from autoimmune destruction
alpha, delta, PP cells
51
what is produced by alpha cells
glucagon
52
what is produced by delta cells
somatostatin
53
what are PP cells
pancreatic polypeptide producing
54
what mediates islet destruction
T lymphocytes
55
True or false. Islet cell destruction is mediated by islet autoantibodies
false. Mediated by T lymphocytes
56
True or false. Islet cell antibodies are present in the majority of individuals diagnosed with new onset type 1 DM
True
57
Central to the development of type 2 DM
abnormal insulin secretion and insulin resistance
58
most prominent variant of genes associated with type 2 DM
transcription factor 7-like 2 gene
59
prominent feature of type 2 DM
insulin resistance
60
dominant role in insulin resistance
postreceptor defects in insulin regulated phosphorylation/dephosphorylation
61
insulin dose response curve
rightward shift
62
result of decreased peripheral glucose utilization
postprandial hyperglycemia
63
what is the impairment in skeletal muscle metabolism
nonoxidative glucose usage
64
increased hepatic glucose output leads to
fasting hyperglycemia
65
what does righward shift in insulin dose mean
decrease insulin sensitivity
66
what is gluocotoxity
chronic hyperglycemia paradoxically impairs islet function
67
what is lipotoxicity
increased fatty acids also worsen islet function
68
True or false. In the pathogenesis of Type 1 DM, there is pre inflammatory islet atrophy
False. After beta cell destruction, inflammation subsides leading to islet atrophy
69
The dyslipidemia found in Type 2 DM
elevated triglycerides, reduced HDL, increased LDL
70
described a constellation of metabolic derangements that include insulin resistance, hypertension, dyslipidemia, central or visceral obesity, type 2 DM or IGT
metabolic syndrome
71
type of insulin resistance. Undefined defect in the insulin signaling pathway; affects young women characterized by servere hyperinsulinemia, obesity and features of hyperandrogenism
Type A insulin resistance syndrome
72
type of insulin resistance. Characterized by autoantibodies directed at at the insulin receptors. Affects middle aged women; presents with hyperinsulinemia, hyperandrogenism and autoimmune disorders
Type B insulin resistance syndrome
73
advocated physical activity in the prevention of Type 2 DM
30 mins/ day five times a week
74
Heterogenous group of disorders caused by genetic mutations that impact the beta cell function and or pancreatic development with onset less than 6 months of age
permanent neonatal diabetes
75
most common cause of pancreatic agenesis
mutations in GATA6
76
mutation in hepatocyte nuclear transcription factor HNF 4a
MODY1
77
mutation in hepatocyte nuclear transcription factor HNF1a
MODY3
78
mutation in hepatocyte nuclear transcription factor HNF 1b
MODY5
79
progressive decline in glycemic control but may respond to sulfonylureas
MODY3
80
results from mutationn in glucokinase where patient have mild to moderate but stable hyperglycemia that does not respond to oral hypoglycemia agents
MODY2
81
variant caused by mutations in pancreatic and duodenal homeobox1
MODY5
82
percent MODY associated genes as cause of type 2 DM
less than 5%
83
when does the complications of chronic hyperglycemia appear
during the second decade of the hyperglycemia
84
Blood pressure considered hypertension in individuals with diabetes
BP more than 130/80 mmHg
85
when to assess autonomic neuropathy in Type 1 DM? In type 2 DM?
Annually 5 yrs after the initial diagnosis of Type DM, annually starting at the time of diagnosis for Type 2 DM
86
Type 2 DM present with ketoacidosis but lack autoimmune markers
ketosis prone type 2 DM
87
Type 2 DM phenotype but have autoimmune markers
latent autoimmune diabetes of the adult

Endocrine (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions