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Pathology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is diabetes insipidus?

A

deficiency of antidiuretic hormone

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2
Q

How many amino acids is insulin made up of?

A

51

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3
Q

What do the beta cells of Langerhans produce?

A

Insulin, glucagon and pancreatic polypeptides

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4
Q

What type of tissues can create a large carbohydrate reserve?

A

Skeletal muscle cells and fat cells

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5
Q

What cells do not require insulting for glucose uptake but are incapable of having large carbohydrate stores?

A

Neurons

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6
Q

What are the actions of insulin?

A
  • uptake of glucose by cells
  • uptake of amino acids by cells
  • increased glycogen synthesis
  • increased synthesis and esterification of fatty acids
  • decreased lipolysis, proteinolysis and gluconeogenesis
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7
Q

How is insulin release mainly controlled?

A

Direct feedback

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8
Q

What are the acute consequences of insulin deficiency ?

A
  • hyperglycaemia
  • ketosis
  • acidosis
  • hyperosmolar state
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9
Q

What are the chronic consequences of insulin deficiency?

A
  • cardiovascular disease
  • nephropathy
  • neuropathy
  • retinopathy
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10
Q

What are the 4 types of diabetes?

A

Type 1
Type 2
Gestational
Secondary

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11
Q

What are the main elements of Type 1 diabetes?

A

autoimmune destruction of ß-cells
• probably triggered by viral infection
• Coxsackie or rubella viruses
• susceptibility partly dependent on HLA gene subtypes (HLA-DR3/DR4)
• classically starts in childhood, though adult onset not rare

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12
Q

What are the main elements of Type 2 diabetes?

A

pathophysiology complicated
• peripheral insulin resistance
• ß-cell response to glucose delayed or absent
• insulin concentrations normal or high
• strong association with lifestyle
• up to 20% prevalence in the elderly in the USA

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13
Q

What are the main aspects of gestational diabetes?

A

genetic predisposition
• insulin resistance, probably triggered by hormonal changes of pregnancy
• resolves with delivery

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14
Q

What are the risk factors for gestational diabetes?

A 
maternal age
•   family history of DM type 2
•   African or North American native
•   previous gestational diabetes
•   previous baby over 4Kg
•   smoking
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15
Q

What are the dangers for the mother with gestational diabetes?

A 
mother
•   greater risk of DM type 2 later in life
•   hypertension
•   pre-eclampsia or eclampsia
•   obstructed labour
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16
Q

What are the dangers for the child in gestational diabetes?

A 
child
•   risk of DM type 2 later in life
•   risk of obesity later in life
•   macrosomia
•   neonatal hypoglycaemia
•   neonatal jaundice
•   respiratory distress syndrome
17
Q

What conditions cause secondary diabetes?

A
  • chronic pancreatitis
  • cystic fibrosis
  • pancreatic surgery
  • haemachromatosis
  • endocrine disease
  • eg Cushing’s syndrome
  • drug therapy
  • eg corticosteroids
18
Q

What are the symptoms of type 1?

A 
polyuria
•   polydipsia
•   hunger
•   weight loss
•  can be seen in DM type 2, but often camouflaged by other symptoms
19
Q

How can diabetes mellitus present acutely?

A 
ketoacidosis
•   rapid breakdown of fat and protein releases ketones (including acetone) and acids into bloodstream
•   hyperosmolar nonketotic state
•   severe dehydration
•  hypoglycaemia
•   diabetic foot
20
Q

How does DM present chronically?

A
  • Macrovascular
  • ischaemic heart disease
  • stroke
  • peripheral vascular disease
  • Microvascular
  • retinopathy
  • neuropathy
  • nephropathy
  • Cataract
21
Q

What are the two routes of diabetic retinopathy?

A
  • proliferation of blood vessels in the retina
  • retinal haemorrhages
  • macular oedema
  • fluid exudation into retina
22
Q

How does diabetic neuropathy present?

A 
microangiopathy of vasa nervosum
•   peripheral numbness or tingling
•   occasional neuropathic pain
•   muscle weakness
•   autonomic neuropathy
23
Q

How does diabetic nephropathy present?

A
  • microangiopathy of glomerular capillaries
  • pathology: nodular and diffuse glomerulosclerosis
  • clinical: chronic renal failure or nephrotic syndrome; hypertension
24
Q

What is diabetes mellitus?

A
  • deficiency of insulin

* resistance to effects of insulin

Pathology (17 decks)

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