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Physiology of Disease > Diabetic Kidney Disease > Flashcards

Diabetic Kidney Disease Flashcards

1
Q

What two scientists found out insulin prevents diabetes?

A

Best and Banting

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2
Q

what are 2 cell types in the islet of langerhans?

A

Beta cells
alpha cells

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3
Q

What do beta cells secret?

A

Insulin

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4
Q

What do alpha cells secrete?

A

Glucagon

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5
Q

Why is the best way to adminster glucose and why?

A

Oral is the best way to adminster glucose to get insulin response -> specific gut hormones that induce insulin

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6
Q

What are 2 gut hormones that induce the insulin response?

A

GLP-1 and GIP -> gut hormones (incretin response)

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7
Q

What happens when beta cells take up glucose?

A

ATP generation & closure of K+ channel -> membrane depolarization -> calcium entry -> insulin rich granules released

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8
Q

What is the insulin receptor made up of?

A

Polypeptide composed of alpha and beta chains

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9
Q

What type of receptors are insulin receptors?

A

Tyrosine receptor kinases

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10
Q

What glucose transporter translocate to membrane when tyrosine kinase activity increase?

A

GLUT - 4

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11
Q

What are 3 treatments for T1DM?

A

Insulin replacement
Pancreas transplant
beta cell therapy

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12
Q

What is treatment for T2DM?

A

Diet and exercise
Oral hypoglycemic agents

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13
Q

What are examples of oral hypoglycemic agents?

A

Stimulate beta cell insulin secretion
Decrease hepatic production of glucose
Increase glucose sensitivity
incretin mimetics
SGLT2 inhibitors

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14
Q

What are complication associated with diabetes?

A

Retinopathy
Nephropathy
Neuropathy -> amputations
Stroke
CVD

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15
Q

What is the leading cause of end stage renal disease?

A

Diabetic kidney disease

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16
Q

What is the earliest sign of diabetic kidney disease?

A

Microalbuminuria

17
Q

How do you block RAS?

A

ACE inhibitors
ANG receptor blockade

18
Q

What does persistent albuminuria tell us?

A

Kidneys are not filtering properly

19
Q

What happens when GFR goes down?

A

Increase risk of ESRD

20
Q

What are structural changes in DKD?

A

Glomerular enlargement
Celullar hypertrophy (TGF-B)
Tubular interstitial fibrosis
Increased ROS

21
Q

TIF reflects?

A

growth factors
proteinuria
ischemia
hypoxia

22
Q

Which kidney arterioles are constricted in diabetes?

A

Efferent arterioles

23
Q

What can reduce pressure in efferent arterioles?

A

ACE inhibitors

24
Q

Why is progress in this field slow?

A

Mice are not humans - difficult to mimic DKD in mice
Not good biomarkers

25
Q

What is the MoA of SGLT2 inhibtors

A

stop reabsorption of glucose in kidneys which decreased reabsorption of sodium as well -> resloves glomerular hypertension

26
Q

What is MCP?

A

Chemokine that is attracted to monocytes

27
Q

How is inflammation targeted?

A

Anti-inflammatory drugs
JAK-STAT

28
Q
A

Physiology of Disease (15 decks)

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