Endo - Pathology (Diabetes) Flashcards
Pg. 327-328 in First Aid 2014 Sections include: -Diabetes mellitus -Type 1 vs. Type 2 diabetes mellitus -Diabetic ketoacidosis -Insulinoma
What are 4 presenting signs/symptoms of diabetes mellitus? What are 2 conditions associated with diabetes mellitus, and which is type 1 versus type 2 DM?
Polydipsia, polyuria, polyphagia, weight loss; DKA (type 1), Hyperosmolar coma (type 2)
What is a rare cause of diabetes mellitus?
Rarely, can be caused by unopposed secretion of GH and epinephrine
What are the 2 key causes of pathophysiology in diabetes mellitus? What 3 consequences do they have?
Insulin deficiency (and glucagon excess) => Decreased glucose uptake, Increased protein catabolism, & Increased lipolysis
What are 4 effects of decreased glucose uptake in diabetes mellitus?
Decreased glucose uptake => hyperglycemia, glycosuria, osmotic diuresis, electrolyte depletion
What are 2 effects of increased protein catabolism in diabetes mellitus? How do they relate to decreased glucose uptake in diabetes mellitus?
Increased protein catabolism => Increased plasma amino acids, nitrogen los in urine; Can lead to same 4 effects as decreased glucose uptake in diabetes mellitus: hyperglycemia, glycosuria, osmotic diuresis, electrolyte depletion
What are 4 effects of increased lipolysis in diabetes mellitus?
Increased lipolysis => Increased plasma FFAs, Ketogenesis, Ketonuria, Ketonemia
What are 4 general clinical complications that may result from the pathophysiology of diabetes mellitus?
(1) Dehydration (2) Acidosis => (3) Coma (4) Death
Create a diagram demonstrating the pathophysiology and general outcomes of diabetes mellitus.
See p. 327 in First Aid 2014 for visual on left top of page
What are 2 chronic manifestations/processes of diabetes mellitus?
(1) Nonenzymatic glycosylation (2) Osmotic damage
Describe the pathophysiology and effects of nonenzymatic glomerulosclerosis as a chronic manifestation of diabetes mellitus.
(1) Small vessel disease (diffuse thickening of basement membrane) => retinopathy (hemorrhage, exudates, microaneurysms, vessel proliferation), glaucoma, nephropathy (nodular sclerosis, progressive proteinuria, chronic renal failure, ateriolosclerosis leading to hypertension) (2) Large vessel atherosclerosis, CAD, peripheral vascular occlusive disease, and gangrene => limb loss, cerebrovascular disease. MI most common cause of death.
Describe the pathophysiology and effects of osmotic damage as a chronic manifestation of diabetes mellitus.
Osmotic damage (sorbitol accumulation in organs with aldolase reductase and decreased or absent sorbitol dehydrogenase) => (1) Neuropathy (motor, sensory, and autonomic degeneration) (2) Cataracts
What is the most common cause of death in diabetes mellitus patients? What is the pathophysiology behind this?
MI most common cause of death; Nonenzymatic glycosylation => Large vessel atherosclerosis, CAD, peripheral vascular occlusive disease, and gangrene => limb loss, cerebrovascular disease. MI most common cause of death.
What are 3 clinical tests used for diabetes mellitus?
(1) Fasting serum glucose (2) Oral glucose tolerance test (3) HbA1c (reflects average blood glucose over prior 3 months)
What does HbA1c reflect?
HbA1c (reflects average blood glucose over prior 3 months)
What is the mechanism by which retinopathy occurs in diabetes mellitus? What are 2 other conditions/complications that occur this way?
Nonenzymatic glycosylation => Small vessel disease (diffuse thickening of basement membrane) => retinopathy (hemorrhage, exudates, microaneurysms, vessel proliferation), glaucoma, nephropathy (nodular sclerosis, progressive proteinuria, chronic renal failure, ateriolosclerosis leading to hypertension)
What is the mechanism by which limb loss occurs in diabetes mellitus? What are 2 other conditions/complications that occur this way?
Nonenzymatic glycosylation => Large vessel atherosclerosis, CAD, peripheral vascular occlusive disease, and gangrene => limb loss, cerebrovascular disease. MI most common cause of death.
