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Endo II Exam 2 > Diabetes Darrow > Flashcards

Diabetes Darrow Flashcards

1
Q

granuloma annulare

A

type IV rxn

associated with diabetes, thyroid disease, infection, malignancy, drugs

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2
Q

metabolic syndrome

A

2 physical findings
-waist circumference and HTN

3 lab findings
-triglycerides, HDL-C, and glucose

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3
Q

apple

A

bad body shape

-want to be a pear

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4
Q

adipose tissue

A

secretes inflammatory and immune mediators

-adipokines

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5
Q

abdominal fat

A

vs. subQ

causal factor mediating insulin resistance, increased diabetes risk, and cardiovascular disease in metabolic syndrome

dysregulated adipokine secretion, FFA toxicity, macrophage infiltration

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6
Q

obese inflamed fat

A

release of adipokines

low levels of adiponectin

has lots of macrophages

with obesity and insulin resistance

this can promote ectopic lipid accumulation

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7
Q

lean person adipose tissue

A

few macrophages, high adiponectin, low inflammatory cytokines

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8
Q

TZD

A

thiazolinediones

activate PPAR

cause insulin resistance, VEGF angiogenesis inhibiton, increased leptin

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9
Q

TSP1

A

to TGF-beta
to PAI-1 (procoagulant)
to atherosclerosis

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10
Q

with metabolic syndrome

A 
hyperuricemia
larger hyperdense LDL
increased PAI - atherosclerosis
increased platelet adhesion
decreased homocysteine
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11
Q

diagnosis of type II DM

A

random >200 with sx

FBS >126 x2 (pre 100-125)

post meal >200 x2 (pre 140-199)

HBA1C >6.5% x2 (pre 5.7-6.4)

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12
Q

causes of DM II

A

genetic - beta cell fatigue and death
-TCF7L2 - transcription factor in beta cell development

environmental - visceral obesity - insulin resistance

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13
Q

TCF7L2

A

genetic mutation in DM II

Wnt signaling pathway - for beta cell development

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14
Q

vitiligo in DM I?

A

autoimmune - so see mix of sx

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15
Q

polyuria

A

C-DRIPPED

cortisol excess
DM
recovery from renal failure
ions (hyper Ca, hypo K)
parkinsons - nocturnal nocturia
psychogenic polydipsia
enzyme
drugs
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16
Q

Abs in DM I

A 
GAD 65
insulin Abs
islet cell cytoplasmic Abs
insulinoma associated 2
zinc transporter Abs
tyrosine phosphatase Abs
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17
Q

HLA in DM I

A

DR3 and DR4

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18
Q

MODY

A

maturity onset diabetes of youth

defect in TFHNF1
-results in decreased apoM**

decreased clearance of HDL

19
Q

acanthosis nigricans

A

sign of insulin resistance

-DM II

20
Q

TFHNF1

A

with MODY

no apoM - so HDL is high

21
Q

most common MODY

A

type 3

do respond to sulfonylureas

22
Q

MODY syndromes

A

involve impaired glucose induced secretion of insulin

23
Q

high E and NE

A

decrease insulin secretion

  • due to alpha2 adrenergic activation
  • result in hyperglycemia
24
Q

cause of insulin resistance

A

obesity and hyperglycemia

all proteins get glycated

25
Q

drugs causing hyperglycemia

A 
beta blockers
glucocorticoids
antipsychotic - olanzapine
statins
oral contraceptives
pentamidine
cyclosporine
niacin
26
Q

TNF alpha

A

blocks effects of insulin
-muscle, liver, fat

problem of obesity in DM II

27
Q

muscle insulin resistance

A

excess calories - lipogenesis with excess malonyl CoA - blockage of fatty acyl CoA oxiation

byproducts - DAG and ceramide

ceramide activates PKC pathways - inhibit insulin receptor activity

28
Q

eruptive xanthoma

A

hepatic overproduction of VLDL (type 4)

associated with diabetes

29
Q

cheiropathy

A

limited joint mobility

can’t prayer sign hands

with diabetes

30
Q

coronary artery disease equivalents

A

DM
cerebral arterial disease
aortic aneurysm
PVD

31
Q

most diabetics

A

on statins - coronary artery disease equivalent

32
Q

type IIb hyperlipidemia

A

increased heaptic secretion of apoB100 and VLDL

no xanthomas

33
Q

hypoglycemia

A

insulinoma

34
Q

whipples triad

A

insulinoma if:

1 signs and sx of hypoglycemia
2 low glucose at time of event (<50)
3 reversal with correction of hypoglycemia

35
Q

sympathoadrenal signs

A

glucose <60

sweating, tachycardia, tachypnea, anxiety, tremors, nausea

more with post-prandial

36
Q

neuroglycopenic signs

A

glucose <50

blurry vision, fatigue, dizzy, HA, seizure, confused, coma, death

more with fasting

37
Q

diagnosis of insulinoma

A

72 hour fast

with insulin and glucose measure

38
Q

insulinomas

A

80% are benign pancreatic adenoma

tx - surgery

39
Q

diazoxide

A

opens K channels - to stop insulin secretion in insulinoma

40
Q

in hypoglycemia

A

should see low glucose and low insulin

41
Q

C-peptide present in hypoglycemia

A

taken sulfonylurea drug**

42
Q

C peptide absent

A

taken too much insulin**

43
Q

nesidioblastoma

A

noninsulinoma pancreatogenous hypoglycemia syndrome

pancreatic cell hyperplasia

post prandial hypoglycemia

Endo II Exam 2 (16 decks)

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