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Year 2 Clinical Pathology > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What is diabetes?

A

A syndrome of chronic hyperglycaemia due to various causes

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2
Q

What is diabetes?

A

A syndrome of chronic hyperglycaemia due to various causes

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3
Q

What 2 other conditions do patients with diabetes often have?

A

Hyperlipidaemia and hypertension

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4
Q

What is the normal level of blood glucose within the blood?

A

5mmol/L

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5
Q

High blood sugar promotes release of what hormone from the pancreas?

A

Insulin

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6
Q

Low blood sugar promotes the release of what hormone from the pancreas?

A

Glucagon

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7
Q

Which organ is integral to maintaining blood sugar and is under the influence of both glucagon and insulin?

A

The liver

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8
Q

What are the 2 main actions of insulin?

A

1) Stimulates glucose uptake from the blood into all tissues

2) Promotes the conversion of glucose to glycogen in the liver

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9
Q

What is the main action of glucagon?

A

Stimulates breakdown of glycogen to glucose in the liver to be released into the blood stream

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10
Q

Which blood sugar levels define hypoglycaemia?

A
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11
Q

What blood sugar level defines hyperglycaemia?

A

> 11mmol/L

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12
Q

What is a syndrome?

A

A collection of symptoms and signs that may be due to more than one cause

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13
Q

What are the 4 main symptoms of diabetes?

A

1) Thirst
2) Polyuria
3) Weight loss
4) Tiredness

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14
Q

What are the 4 main signs of diabetes?

A

1) Dry mouth
2) Weight loss
3) Glycosuria
4) Hyperglycaemia

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15
Q

What percentage of the Leeds population suffers from diabetes?

A

40%

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16
Q

In which 2 groups is diabetes most prevalent?

A

1) Asians

2) Afro-Caribbeans

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17
Q

What would be a normal and a diabetic fasting blood glucose?

A

Normal = 7mmol/L

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18
Q

What would be a normal and a diabetic fasting blood glucose?

A

Normal = 7mmol/L

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19
Q

What 2 other conditions do patients with diabetes often have?

A

Hyperlipidaemia and hypertension

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20
Q

What is the normal level of blood glucose within the blood?

A

5mmol/L

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21
Q

High blood sugar promotes release of what hormone from the pancreas?

A

Insulin

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22
Q

Low blood sugar promotes the release of what hormone from the pancreas?

A

Glucagon

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23
Q

Which organ is integral to maintaining blood sugar and is under the influence of both glucagon and insulin?

A

The liver

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24
Q

What are the 2 main actions of insulin?

A

1) Stimulates glucose uptake from the blood into all tissues

2) Promotes the conversion of glucose to glycogen in the liver

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25
Q

What is the main action of glucagon?

A

Stimulates breakdown of glycogen to glucose in the liver to be released into the blood stream

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26
Q

Which blood sugar levels define hypoglycaemia?

A
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27
Q

What blood sugar level defines hyperglycaemia?

A

> 11mmol/L

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28
Q

What is a syndrome?

A

A collection of symptoms and signs that may be due to more than one cause

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29
Q

What are the 4 main symptoms of diabetes?

A

1) Thirst
2) Polyuria
3) Weight loss
4) Tiredness

30
Q

What are the 4 main signs of diabetes?

A

1) Dry mouth
2) Weight loss
3) Glycosuria
4) Hyperglycaemia

31
Q

What percentage of the Leeds population suffers from diabetes?

A

40%

32
Q

In which 2 groups is diabetes most prevalent?

A

1) Asians

2) Afro-Caribbeans

33
Q

A diagnosis of diabetes can be made on the grounds of 1 of what 4 findings?

A

1) Typical symptoms and a high RANDOM blood glucose
2) Fasting blood glucose >7mmol/L
3) 75g Oral glucose tolerance test
4) HbA1c; 48mmol/mol (6.5%)

34
Q

What would be a normal and a diabetic fasting blood glucose?

A

Normal = 7mmol/L

35
Q

What is an oral glucose tolerance test, what would be a diabetic result?

A

Patient is fasting then given a 75g oral glucose load
2 hour post glucose load the blood sugar level is measured
Diabetic = >11mmol/L

36
Q

What is the other method of carrying out a glucose tolerance test?

A

IV

37
Q

What are the fasting blood glucose and glucose tolerance test levels seen as borderline diabetic?

A

Fasting blood glucose: 6-7mmol/L

2 hour glucose levels: 7.8-11 mmol/L

38
Q

What 4 investigations in addition to blood glucose are important in diabetes?

A

1) HbA1c
2) Renal function
3) Liver function
4) Lipids
5) Thyroid function

39
Q

What is ketosis prone type 2 diabetes?

A

A variant of type 2 DM, ketosis occurs when patient is physically stressed with intercurrent illness, temporarily requires insulin but its not insulin dependent

40
Q

What is the use of HbA1c?

A

Can be used to assess the degree of glycaemic control as it reflects glucose levels over the last 120 days

41
Q

A patient on diabetic therapy would have a high HbA1c for one of what 2 reasons?

A

1) The treatment isn’t working

2) The patient is not adhering to their treatment

42
Q

Give 2 drug therapies which can induce diabetes?

A

1) Steroids

2) Anti psychotics

43
Q

What is type 1 diabetes?

A

Insulin dependent. Autoimmune destruction of the insulin producing islet beta cells, cant produce insulin.

44
Q

Is type 1 diabetes commonly diagnosed in the young or old?

A

Young

45
Q

What 3 auto Ab tests would you do is suspected type 1 DM?

A

1) ICA
2) IA2
3) GAD

46
Q

If a patient had type 1 diabetes, what kinds of conditions would you expect to see in that patients PMH or FH?

A

Other endocrine disorders

47
Q

What is insulitis?

A

Lymphocytic infiltration of the islets of Langerhans - occurs in Type 1 DM

48
Q

What is LADA?

A

Late autoimmune diabetes in adults

49
Q

LADA tends to affect which group of patients?

A

Older females

50
Q

How does LADA present?

A

Presents as type 2 diabetes
Patients then have deterioration in control, becoming increasingly reliant on therapy
Autoantibodies then found
Patient reclassified as LADA

51
Q

What 4 Ab tests are carried out in LADA?

A

1) GAD
2) ICA
3) tTG
4) TPO

52
Q

What 6 conditions relating to LADA are often found in the families of PMH of patients with LADA?

A

1) Type 1 DM
2) Thyroid
3) PA (propionic acidaemia)
4) Addison’s
5) Coeliac
6) Vitiligo

53
Q

What is type 2 diabetes?

A

Insulin deficient or resistant diabetes, not absolutely insulin dependent and often associated with obesity

54
Q

What 2 conditions are commonly found in conjunction with type 2 DM?

A

1) Hypertension

2) Hyperlipidaemia

55
Q

Is type 2 diabetes genetic?

A

Not completely genetic but known to have some genetic involvement as shows strong family history

56
Q

Ketosis prone type 2 DM often occurs in which group?

A

Often obese, ethnic minority

57
Q

Diabetes can be secondary to disorders of what organ?

A

Pancreatic disorders

58
Q

What 5 pancreatic disorders can lead to diabetes?

A

1) Chronic or acute pancreatitis
2) Calcific, tropical pancreatitis
3) Pancreatectomy
4) Pancreatic cancer
5) Cystic fibrosis
6) Haemochromatosis

59
Q

What is haemochromatosis?

A

Inherited disorder in which you absorb too much iron and suffer with iron overload - iron gets deposited in many tissues including the pancreas

60
Q

What 4 drugs can cause drug induced diabetes?

A

1) Diuretics
2) Steroids
3) Antipsychotics eg. Olanzapine
4) Psychiatric drugs: weight gain

61
Q

What 3 endocrine disorders can cause diabetes?

A

1) Acromegaly - high GH
2) Cushing’s syndrome - high cortisol
3) Phaeochromocytoma

62
Q

What are the 5 ethnic variants of diabetes?

A

1) J type diabetes: Jamaican diabetes, Afro-caribbeans
2) Flatbush diabetes: US Afro-Americans
3) MRDM: malnutrition-related diabetes, tropic diabetes
4) Chronic calcific pancreatitis: secondary diabetes
5) Z type diabetes

63
Q

What is the other name for J type Jamaican diabetes?

A

Flatbush diabetes

64
Q

What are the 4 characteristics of J type diabetes?

A

1) Ketosis prone
2) Not particularly obese
3) On and off insulin therapy
4) Variable insulin requirements

65
Q

What 2 genetic syndromes cause diabetes?

A

1) Friedreich’s ataxia

2) Dystrophia myotonica

66
Q

What is gestational diabetes?

A

Diabetes which appears during pregnancy and resolves after pregnancy

67
Q

Does gestational diabetes increase the risk of developing diabetes in the future?

A
  • Have a risk of diabetes in a later pregnancy

- At risk of diabetes in the future

68
Q

What is MODY?

A

Maturity onset diabetes in the young - a rare genetic form of diabetes

69
Q

Is MODY inherited?

A

Yes - autosomal dominant pattern

70
Q

Is insulin required in MODY?

A

Not initially

71
Q

What is the age of onset of MODY?

A

Before 25

72
Q

MODY can be caused by a mutations in which 3 genes?

A

1) Glucokinase
2) HNF 1A
3) HNF 4A

Year 2 Clinical Pathology (64 decks)

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