Endocrine

Question 1

What is Type 1 Diabetes Mellitus?

Answer 1

A disease which is caused by the autoimmune destruction of the beta cells of the islets of langerhans.

Question 2

Which immune cell is known to propagate the destruction of the beta cells of the islets of langerhans?

Answer 2

T cells

Question 3

What are 4 key clinical features of type 1 diabetes mellitus?

Answer 3

Polyuria

Polydipsia

Weight loss

Nocturnal polyuria (OR Secondary nocturnal enuresis)

Question 4

How do you diagnose DM1?

Answer 4

Blood glucose >11.1mmol/L (fasting >7mmol/L)

Glycosuria

Ketone in urine

Glucose in urine

Question 5

What is the main part of Type 1 Diabetes Mellitus management?

Answer 5

Education

Question 6

What is the triad needed in Diabetic Ketoacidosis (DKA)?

Answer 6

Diabetes (>11.1mmol/L)

Ketonaemia (or ketones in urine)

Acidosis (pH <7.3)

Question 7

How does high glucose lead to high ketones?

Answer 7

The body is getting rid of all the natural stores of glucose in urine and blood, so it has to make new forms of energy through burning lipids.

This causes lipolysis. From lipolysis, we get free fatty acids and triglycerides, which are further into ketones.

That is why in starvation we go into ketosis; because we start breaking down fats for energy.

Question 8

What are the clinical features of DKA?

Answer 8

Abdominal pain

Kussmaul breathing

Acetone smelling breath

Dehydration and reduced consciousness

Diabetes clinical features (polyuria, polydipsia etc)

Question 9

How is DKA managed?

Answer 9

FLUID RESUSCITATION!

(but be careful, because fluid resuscitation can cause cerebral oedema - fluid intake needs to be monitorred religiously)

Insulin

Correct hyperkalaemia

Question 10

What is Maturity Onset Diabetes of the Young (MODY)?

Answer 10

Diabetes (different from type 1 and 2 diabetes) which is caused by a mutation in a single gene.

Comes on before the age of 25