Diabetes Mellitus Pathology Flashcards
Which cells can respond to insulin?
adipose tissue
striated muscle
liver
What are the major changes diabetes mellitus cause?
macrovascular
microvascular
cellular
What are the microvascular effects of DM?
kidney diabetic nephropathy
retina diabetic retinopathy
delayed wound healing
What kind of cellular changes is microvascular complication usually associated with?
glycosylation of proteins that is initially reversible, but later becomes stable
What is papillary necrosis?
coagulative necrosis of deep medullary pyramids
What do kidneys of late stage diabetic patients look like?
scarred with nodular appearance due to macro and micro-vascular injuries
What is Kimmelstiel Wilson nodules?
Spherical nodules arising in mesangium and eventually becoming balls of collagen
Does the wall thickening cause protein leakage?
No, it’s more because of the disturbance of charge on the basement membrane
How does diabetes cause retinopathy
primarily due to ischaemia related to microvascular injury and reduced perfusion
Why is foot care a critical part of managing DM
neuropathy - can’t feel injury, and consequently frequent trauma
impaired healing
impaired immune system
T/F AGEs are normal molecules in the body
True, but the formation speeds up in hyperglycaemia
What is the effect of AGE when binding to RAGE ?
binding to receptor RAGE on inflammatory cells, endothelial cells and vascular smooth muscle
What is the effect of AGE cross linking with extracellular matrix proteins
cross link with type I collage to cause vessel injury
cross link to type IV collagen to alter BM permeability
cross link to protein, making them resistant to degradation
AGE matrix can trap LDL to accelerate atheroma
What is the effect of inappropriately activating PKC?
pro-angiogenic
increase tendency to small vessel constriction
induce production of BM and matrix
pro-inflammatory cytokine release
What kind of liver disease does DM cause?
NASH
