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MSE - 2006 Clinical Physiology > carbohydrate metabolism disorder > Flashcards

carbohydrate metabolism disorder Flashcards

1
Q

what are the glucose metabolism

A

glycolysis

kerb cycle

oxidative phosphorylation

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2
Q

what is glycolysis and what does it produce?

A

Break down glucose and produce pyruvate

Produces 2 ATP and 2NADH

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3
Q

what is the primary regulatory hormone in glucoregulation?

A

insulin

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4
Q

action of the insulin

A

binds to extracellular alpha-subunits

which cause a conformational change

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5
Q

role of insulin on glucose

A

insulin facilitates the translocation of GLUT-4 from vesicles to the cell membrane

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6
Q

What does GLUT-4 do?

A

Forms a pore that allows glucose to diffuse into the cells

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7
Q

where is glucose stored?

A

liver in the form of glycogen

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8
Q

does insulin have any relation with rate of glycogen synthesis?

A

yes

insulin increases the rate of glycogen synthesis by activating glycogen synthase

insulin decrease the rate of glycogen breakdown

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9
Q

what other function does insulin have other than glucose synthesis?

A

increase lipogenesis

promotes protein synthesis

counter-regulatory hormones

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10
Q

what does hyperglycaemia mean?

A

high blood sugar level

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11
Q

What is diabetes mellitus

A

most prevalent cause of hyperglycaemia

lack of / insensitivity to insulin

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12
Q

type 1 DM

A

absolute lack of insulin

cause by autoimmune destruction of pancreatic beta cells

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13
Q

what are pathogenesis of type 1 DM?

A

lymphocytes infiltrate into pancreatic islets and destroy B-cells

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14
Q

symptoms of type 1 DM

A
  • thirst
  • polyuria / nocturia
  • dehydration
  • fatigue
  • diabetic ketoacidosis
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15
Q

what’s so special about diabetic ketoacidosis?

A

occurs in type 1 DM only

insulin deficiency that can cause:
- gluconeogenesis
- glycogenesis
- decreased peripheral utilization of glucose
increased metabolism of fatty acids and ketones as energy substrates

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16
Q

what is shock

A

insufficient blood circulating into the tissues

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17
Q

what are the types of shock

A

Hypovolemic
Cardiogenic
Obstructive
Distributive

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18
Q

what is obstructive shock

A

anatomical blockage of the great vessels of the heart

which leads to decreased venous return, increased afterload, and decreased cardiac output

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19
Q

what is cardiogenetic shock

A

a life-threatening condition in which your heart suddenly can’t pump enough blood to meet your body’s needs

20
Q

What is hypovolemic shock

A

an emergency condition in which severe blood or other fluid loss, then makes the heart unable to pump enough blood to the body
cause organs to stop working

21
Q

what is distributive shock

A

a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in an inadequate supply of blood to the body’s tissues and organs.

22
Q

how can we manage type 1 DM

A

exogenous insulin

pancreas transplant

islet cell transplant

artificial pancreas

23
Q

what are the treatment of DKA

A
  • insulin
  • fluid replacement
  • potassium (ONLY if the patient is hypokalaemic)
  • bicarbonate
24
Q

what is hypokalaemia

A

low potassium level in your blood stream

25
Q

causes of cerebral oedema

A

inflammation
fluid overload
coagulopathy

26
Q

what is diabetes mellitus type 2

A

insulin resistance - decreased biological response to normal insulin levels

mechanism unclear - defect in intracellular signalling pathway for insulin receptor to be active

27
Q

what is diabetic nephropathy

A

progressive kidney disease

caused by damage to the capillaries in the kidney glomeruli

lead to end stage i.e. renal failure

28
Q

define chronic complications

A

long-term problems that can developm gradually

29
Q

define acute complications

A

short-term problem that can happen anytime

30
Q

types of chronic complication of diabetes

A 
retinopathy
Nephropathy
Neuropathy
ischaemic heart disease
cerebrovascular disease
peripheral vascular disease
31
Q

where will Diabetic nephropathy first affects?

A

glomerular basement membrane (GBM)

32
Q

how will DN cause a problem?

A

Increase glycoprotein in glomeruli

change in permeability and increase in hydrostatic pressure

33
Q

treatment for diabetic nephropathy

A

improved glycaemic control

treatment with anglotensin converting enzyme inhibitor (ACE)

34
Q

what is diabetic retinopathy

A

caused by microvascular complication

35
Q

how does diabetic retinopathy affects us

A

microanuerysms burtst causing occlusion of sight

36
Q

why do complications hppen

A

hyperglycaemia promotes non-enzymatic attachment of glucose to protein molecules

schiff base <== glucose + non-enzymatic
v
changes physical / biochemical structure
v
reduces its solubility and result in cataract formation

37
Q

What are the macrovascular disease (give example)

A

big vessel disease

i.e. heart disease
cerebrovascular disease

38
Q

prevention of macrovascular disease

A 
stop smoking
reduce cholesterol level
arterial surgery
angioplasty
stents
39
Q

What is hypoglycaemia

A

where plasma glucose is < 2.2mmol/L

40
Q

symptoms of hypoglycaemia during sleep

A

crying out or having nightmares
sweating enough to make your pj / sheets damp
feeling tired, irritable to confused after waking up

41
Q

What causes hypoglycaemia

A

error of metabolism

  • galactosaemia
  • hereditary fructose intolerance
  • glucogen storage disease
42
Q

what is galactosaemia

A

galactokinase deficiency

metabolic disorder

43
Q

how many types in galactosaemia

A

3

44
Q

why is hypoglycaemia so significance

A

lactose is broken down into glucose and galactose

toxin level buid up
galactose-1-phosphate ==> galactitol

45
Q

causes of hypoglycaemia

A

liver disease
endocrine disease
adrenal failure
stress

MSE - 2006 Clinical Physiology (6 decks)

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