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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
What is the main action of glucagon?
Stimulates breakdown of glycogen to glucose in the liver to be released into the blood stream
26
Which blood sugar levels define hypoglycaemia?
27
What blood sugar level defines hyperglycaemia?
>11mmol/L
28
What is a syndrome?
A collection of symptoms and signs that may be due to more than one cause
29
What are the 4 main symptoms of diabetes?
1) Thirst 2) Polyuria 3) Weight loss 4) Tiredness
30
What are the 4 main signs of diabetes?
1) Dry mouth 2) Weight loss 3) Glycosuria 4) Hyperglycaemia
31
What percentage of the Leeds population suffers from diabetes?
40%
32
In which 2 groups is diabetes most prevalent?
1) Asians | 2) Afro-Caribbeans
33
A diagnosis of diabetes can be made on the grounds of 1 of what 4 findings?
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
What would be a normal and a diabetic fasting blood glucose?
Normal = 7mmol/L
35
What is an oral glucose tolerance test, what would be a diabetic result?
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
What is the other method of carrying out a glucose tolerance test?
IV
37
What are the fasting blood glucose and glucose tolerance test levels seen as borderline diabetic?
Fasting blood glucose: 6-7mmol/L | 2 hour glucose levels: 7.8-11 mmol/L
38
What 4 investigations in addition to blood glucose are important in diabetes?
1) HbA1c 2) Renal function 3) Liver function 4) Lipids 5) Thyroid function
39
What is ketosis prone type 2 diabetes?
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
What is the use of HbA1c?
Can be used to assess the degree of glycaemic control as it reflects glucose levels over the last 120 days
41
A patient on diabetic therapy would have a high HbA1c for one of what 2 reasons?
1) The treatment isn't working | 2) The patient is not adhering to their treatment
42
Give 2 drug therapies which can induce diabetes?
1) Steroids | 2) Anti psychotics
43
What is type 1 diabetes?
Insulin dependent. Autoimmune destruction of the insulin producing islet beta cells, cant produce insulin.
44
Is type 1 diabetes commonly diagnosed in the young or old?
Young
45
What 3 auto Ab tests would you do is suspected type 1 DM?
1) ICA 2) IA2 3) GAD
46
If a patient had type 1 diabetes, what kinds of conditions would you expect to see in that patients PMH or FH?
Other endocrine disorders
47
What is insulitis?
Lymphocytic infiltration of the islets of Langerhans - occurs in Type 1 DM
48
What is LADA?
Late autoimmune diabetes in adults
49
LADA tends to affect which group of patients?
Older females
50
How does LADA present?
Presents as type 2 diabetes Patients then have deterioration in control, becoming increasingly reliant on therapy Autoantibodies then found Patient reclassified as LADA
51
What 4 Ab tests are carried out in LADA?
1) GAD 2) ICA 3) tTG 4) TPO
52
What 6 conditions relating to LADA are often found in the families of PMH of patients with LADA?
1) Type 1 DM 2) Thyroid 3) PA (propionic acidaemia) 4) Addison's 5) Coeliac 6) Vitiligo
53
What is type 2 diabetes?
Insulin deficient or resistant diabetes, not absolutely insulin dependent and often associated with obesity
54
What 2 conditions are commonly found in conjunction with type 2 DM?
1) Hypertension | 2) Hyperlipidaemia
55
Is type 2 diabetes genetic?
Not completely genetic but known to have some genetic involvement as shows strong family history
56
Ketosis prone type 2 DM often occurs in which group?
Often obese, ethnic minority
57
Diabetes can be secondary to disorders of what organ?
Pancreatic disorders
58
What 5 pancreatic disorders can lead to diabetes?
1) Chronic or acute pancreatitis 2) Calcific, tropical pancreatitis 3) Pancreatectomy 4) Pancreatic cancer 5) Cystic fibrosis 6) Haemochromatosis
59
What is haemochromatosis?
Inherited disorder in which you absorb too much iron and suffer with iron overload - iron gets deposited in many tissues including the pancreas
60
What 4 drugs can cause drug induced diabetes?
1) Diuretics 2) Steroids 3) Antipsychotics eg. Olanzapine 4) Psychiatric drugs: weight gain
61
What 3 endocrine disorders can cause diabetes?
1) Acromegaly - high GH 2) Cushing's syndrome - high cortisol 3) Phaeochromocytoma
62
What are the 5 ethnic variants of diabetes?
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
What is the other name for J type Jamaican diabetes?
Flatbush diabetes
64
What are the 4 characteristics of J type diabetes?
1) Ketosis prone 2) Not particularly obese 3) On and off insulin therapy 4) Variable insulin requirements
65
What 2 genetic syndromes cause diabetes?
1) Friedreich's ataxia | 2) Dystrophia myotonica
66
What is gestational diabetes?
Diabetes which appears during pregnancy and resolves after pregnancy
67
Does gestational diabetes increase the risk of developing diabetes in the future?
- Have a risk of diabetes in a later pregnancy | - At risk of diabetes in the future
68
What is MODY?
Maturity onset diabetes in the young - a rare genetic form of diabetes
69
Is MODY inherited?
Yes - autosomal dominant pattern
70
Is insulin required in MODY?
Not initially
71
What is the age of onset of MODY?
Before 25
72
MODY can be caused by a mutations in which 3 genes?
1) Glucokinase 2) HNF 1A 3) HNF 4A

Year 2 Clinical Pathology (64 decks)

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