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Revision for year 5 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Metabolic syndrome features

A

BP - more than 140/90
Central obesity - more than 94cm in males (37 inches) and 80 cm in F (31 inches)
FASTING hyperglycemia over 6mmol/L
Dyslipidemia - decreased HDL <1mmol/L and increased TGs >2mmol/L
Microalbuminemia

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2
Q

Diabetes diagnostic levels

A

Fasting glucose >7mmol/L
Random plasma glucose >11.1
HbA1c >48

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3
Q

T2DM cause

A

Linked to metabolic syndrome and insulin resistance

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4
Q

T1DM cause

A

CD4 and CD8 destruction of beta cells in islets of langerhans

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5
Q

Describe the EXOCRINE function of the pancreas

A

Produces HCO3 and digestive enzymes - lipase, amylase, protease

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6
Q

What two hormones stimulate the production of HCO3 and digestive enzymes (separately), and where are they produced?

A

SECRETIN is produced by S cells of the DUODENUM, stimulates HCO3 secretion to buffer gastric acid

CCK - produced by I cells, stimulates digestive enzyme release

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7
Q

Where are the exocrine stuff released by the pancreas?

A

Into acinar ducts by acinar cells

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8
Q

Where is the endocrine stuff of the pancreas released from and to?

A

Islets of Langerhans, released into bloodstream

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9
Q

Islets of Langerhans - cells and function

A

Alpha cells - glucagon
Beta cells - insulin
Delta cells - releases somatostatin, which regulates the alpha and beta cells
D1 - vasoactive peptide which stimulates water movement into pancreas
PP - pancreatic polypeptide, self regulates secretion activities

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10
Q

What is C-peptide? What do low levels of it suggest?

A

A breakdown product of pro-insulin (it is broken down into c peptide and insulin), therefore if low, suggests insulin deficiency

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11
Q

What causes acute pancreatitis?

A

IGETSMASHED

H= hyperlipidemia
E = ERCP
D = drugs

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12
Q

Symptoms of acute pancreatitis

A

Severe abdo pain, radiating to the back, relieved by sitting forward

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13
Q

Symptoms of acute pancreatitis

A

Severe abdo pain, radiating to the back, relieved by sitting forward

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14
Q

What markers are elevated in acute pancreatitis? Which is better clinically?

A

Amylase - mildly elevated
Lipase - better marker

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15
Q

What is seen on histology of acute pancreatitis?

A

Coagulative necrosis

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16
Q

Complications of acute pancreatitis

A

Hypocalcemia - due to digestive enzymes mixing with visceral fat, resulting in calcium soaps (fat necrosis)

Hypoglycemia

Shock

17
Q

Name three patterns of damage

A

Periductal (obstruction)
Perilobular (ischemia)
Pan lobular (all three)

18
Q

Name another cause of diabetes related to the pancreas

A

Chronic pancreatitis

19
Q

Causes of chronic pancreatitis

A

ALCOHOL
CYSTIC FIBROSIS
IGG4 AUTOIMMUNE
STONES/TUMOURS/OBSTRUCTION

20
Q

Symptoms of chronic pancreatitis + complication

A

Abdo pain, radiates to back
Weight loss due to malabsorption

Complications
DIABETES
Cancer
Pseudocysts

21
Q

Histology of chronic pancreatitis

A

Fibrosis, loss of exocrine parenchyma, calcification, duct dilation, thick secretions

22
Q

What liver pathology can diabetes cause?

A

NAFLD

23
Q

What is NAFLD? What are the two types?

A

NAFLD is hepatic steatosis in non-alcoholics = too much fat in liver

Simple steatosis = benign fatty infiltration
NASH = non-alcoholic steatohepatitis = fatty infiltration AND inflammation

24
Q

Consequence of a particular type of NAFLD?

A

NASH can lead to cirrhosis

25
Q

Name a congenital disorder that can lead to diabetes

A

Haemochromatosis

26
Q

Haemochromatosis
Problem
Staining
Investigations
Symptoms
Mx

A

Staining - Prussian blue stain

Problem - Iron deposition disorder due to mutation at HFE gene at 6p21.3, leading to increased iron absorption in gut and deposition around the body, which can lead to various problems (cardiomyopathy, hypogonadism)

AUTOSOMMAL RECESSIVE

Invx - Raised ferritin, iron, and reduced total iron binding capacity

Symptoms - bronze skin, diabetes, hepatomegaly/cirrhosis, cardiomegaly, hypogonadism

Epidemiology - middle aged caucasians
Desferoxiamine

Revision for year 5 (45 decks)

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