Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrinology > Epidemiology and Pathophysiology (Diabetes) > Flashcards

Epidemiology and Pathophysiology (Diabetes) Flashcards

1
Q

What is glucose?

A

carbon-based, efficient fuel molecule used for energy
The brain needs a continuous supply to work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the average normal fasting blood glucose?

A

70-99 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

After a meal, what happens to blood glucose levels?

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The majority of glucose from a meal gets ____.

A

stored

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

storage molecule for glucose in the liver, skeletal muscle

A

glycogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

if liver and skeletal muscle are saturated with glycogen, what happens to the excess sugar?

A

formed into triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

During fasting periods when blood glucose levels fall, what happens with glucose?

A

Glycogen is broken down to release glucose
Glucose from skeletal muscle can be used by muscle cell
Liver makes new glucose with gluconeogenesis from amino acids, glycerol, and lactic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens in fat metabolism?

A

Triglycerides are converted to fatty acids and glycerol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens to glycerol?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to fatty acids?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happens in protein metabolism?

A

Excess amino acids are converted to fatty acids, ketones, or glucose
Most are stored in form of proteins manufactured by the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the function of the exocrine pancreas?

A

secrete digestive enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the function of pancreatic acini?

A

secrete digestive juices into the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Whaat is the function of the islets of langerhans?

A

secrete hormones into the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the function of beta cells?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alpha cells?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Insulin is made by the _____ in the _____

A

beta cells, islets of langerhans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Insulin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

insulin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

insulin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

C-peptide is a _____ and can be used to determine if patient is ____

A

waste product, actually releasing insulin or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Slide questionns

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Slide questioms

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does glucose bind to?

A

GLUT transporter proteins (GLUT-2 and GLUT-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why are GLUT-2 transporters important?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why are GLUT-4 transporters important?

A

Found on skeletal muscle, adipose tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

As glucose is phosphorylated,

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

glucose-mediated release of insulin from the beta cell picture

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the biggest role of insulin in the body?

A

Glucose metabolism
Encourages glucose transport into skeletal muscle and adipose tissue
Increases synthesis of glycogen and decreases gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the role of insulin in fat metabolism?

A

Increases transport of fatty acids into adipose cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the role of insulin in protein metabolism

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Where is glucagon produced?

A

Alpha cells in islets of langerhands in the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the impact of glucagon on glucose metabolism?

A

increased gluconeogenesis
increased glycogen breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Fat metabolism

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Protein metabolism

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is amyline?

A

released by beta cells along with insulin and c-peptide
works with insulin to regulate plasma glucose concentrations
decreases postprandial glucagon secretion
slows gastric emptying and increases satiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is somatostatin?

A

inhibits release of many hormones, including insulin and glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is incretins?

A

gut-derived hormones that promote insulin release after oral nutrient load

39
Q

How is epinephrine related to glucose?

A

promotes glycogenolysis in liver and muscle tissue; lipolysis in adipose tissues
Decreases release of insulin in pancreas

40
Q

How is growth hormone related to glucose?

A

Normally inhibited by insulin and elevated glucose levels

41
Q

How are glucocorticoids related to glucose?

A

increases gluconeogenesis in liver

42
Q

Check online slides for a question

A
43
Q

Disorder characterized by an imbalance between insulin availability and insulin need

A

Diabetes Mellitus

44
Q

What is in common between diabetes mellitus and diabetes insipidus?

A

Both make a lot of urine

45
Q

Diabetes is the _____ cause of death in US

A

8th (and contributes to the development of other chronic diseases)

46
Q

Most patients in the US have type ___ diabetic

A

2

47
Q

15% of adults have _____ and 11% of adults have ____

A

diabetes, prediabetes

48
Q

Type of diabetes characterized by near-absence or total absence of insulin

A

Type I DM

49
Q

Most type1 diabetes are type ____

A

1A

50
Q

Associated with insulin resistance, inadequate insulin secretion and increased glucose production

A

Type II DM

51
Q

What can cause other forms of diabetes?

A

destruction of pancreas, genetic defects in glucose or insulin metabolism, gestational

52
Q

how common is gestational DM?

A

7% of US pregnancies

53
Q

Why do you think we avoid terms like “NIDDM” or “juvenile DM” in modern medicine?

A

It can be present in kids or adults so terms are not accurate

54
Q

What causes type IA DM?

A

most autoimmune destruction of beta cells

55
Q

What causes type IB DM?

A

Idiopathic, no associated autoantibodies

56
Q

What are the underlying causes of Type IA DM?

A

HLA genes and environment

57
Q

What environmental factors could increase TYpe IA DM?

A

cow’s milk, hygiene hypothesis, certain viruses

58
Q

very slow progression of type IA DM

A

latent autoimmune diabetes in adults

59
Q

How are beta cells destroyed in type IA DM?

A

Islets of langerhans become infiltrated by lymphocytes
Exact mechanism not fully understood, immunologic

60
Q

What are immunologic markers of type IA DM?

A

autoantibodies to islet molecules: anti-GAD65, anti-ZnT8, Islet cell, autoantibodies, and anti-insulin

61
Q

What are limitations of use of immunologic markers of type IA DM?

A

decline with increasing duration of disease
+ in about 5% of pts with T2DM and gestational diabetes
Low IAA levels in many patients after treatment with exogenous insulin

62
Q

Why would we see declining autoantibodies as type IA progresses

A
63
Q

In type II diabetes, what happens to insulin?

A

Patient’s make enough insulin but tissues are resistant leading to inadequate insulin secretion

64
Q

What are the underlying causes of type II DM?

A

Genetic: multiple loci associated with increased risk
environmental: obesity, nutrition, physical activity, high or low birth weight

Over 80% of T2DM patients overall are obese (visceral)

65
Q

How do you think we could distinguish visceral and subcutaneous obesity?

A

Distribution of fat or calipers

66
Q

What metabolic abnormalities are present in type II DM

A

impaired insulin secretion and insulin resistance
Excessive hepatic glucose production
Abnormal fat/lipid and muscle metabolism

67
Q

What is the pathogenesis of early type II DM

A

insulin resistance leads to compensatory hyperinsulinemia

68
Q

What happens in type II DM over time?

A

Pancreatic beta cells are no longer able to maintain hyperinsulinemic state, causing prediabetic abnormalities
Impaired glucose tolerance
Impaired fasting glucose

69
Q

What causes impaired glucose tolerance?

A

Decreased peripheral tissue glucose uptake and use

70
Q

What causes impaired fasting glucose?

A

Higher than expected fasting glucose levels

71
Q

As disease progresses, what happens in type II DM?

A

further decline in insulin secretion and insulin resistance constribute to consistent, worsening hyperglycemia causing type II DM

72
Q

What is the diabetes triumvirate?

A

Abnormal insulin secretion, increased hepatic glucose production, decreased peripheral glucose uptake

73
Q

Describe the ominous octet of DM

A

Diabetes triumvirate 4) increased lipolysis
5) Decreased incretin effect
6) increased glucagon secretion
7) increased renal glucose reabsorption
8) neurotransmitter dysfunction: insulin normally acts as a appetite suppressant

74
Q

how is increased lipolysis related to type II DM?

A

resistance to insulin’s antilipolytic effect causes release of free fatty acids to stimulate gluconeogenesis

75
Q

What is the pathogenesis of gestational DM?

A

insulin resistance due to metabolic changes of pregnancy

causes increased risk of T2DM in next 10-20 years

76
Q

What is the pathogenesis of maturity-onset diabetes of the young

A

autosomal dominant; genetically mediated impaired insulin secretion in response to glucose

77
Q

Type 1 diabetics are going to end up requiring ____ for survival

A

insulin

78
Q

jhb

A
79
Q

What does metabolic syndrome increase risk of?

A

atherosclerosis, heart disease, stroke, cancer, dementia, type 2 DM, erectile dysfunction

80
Q

What is the criteria for metabolic syndrome?

A

Waist circumference >40 in men >35 in women
Fasting triglycerides >150 mg/dL, or on medication
HDL cholesterol <40 (men) <50 (women)
Blood pressure: 130 mm systolic or >85 mm diastolic or on medication
fasting plasma glucose >100 mg/dL or on medication

81
Q

Metabolic syndrome is also associated with ____

A

small, dense LDL; hyperuricemia; prothrombotic state; proinflammatory state; PCOS; NAFLD

82
Q

What is the prevalence of metabolic syndrome in US?

A

22% of patients

83
Q

What are risk factors for metabolic syndrome?

A

Overweight/obesity
Physical inactivity
Aging- >50
T2DM
Cardiovascular disease: especially women
Lipodystrophy

84
Q

What is the etiology of metabolic syndrome?

A

insulin resistance: increased circulating free fatty acids that feed into insulin resistance, resistance to leptin
glucose intolerance: increased levels of postprandial and fasting glucose
hypertension: loss of insulin’s normal vasodilatory effect, without impacting its mild sodium retention effect
Waist circumference: greater effect of circulating free fatty acids on hepatic metabolism
Dyslipidemia: influx of free fatty acids to liver causing abnormal lipid production
Proinflammatory cytokines: increased production due to the increased overall mass of adipose tissue

85
Q

Etiology

A
86
Q

Etiology

A
87
Q

Etiology

A
88
Q

Etiology

A
89
Q

What are the clinical manifestations of metabolic syndrome?

A

increased waist circumference, hypertension
acanthosis nigricans
hepatic enlargement
hyperuricemia
polycystic ovarian syndrome
obstructive sleep apnea

90
Q

velevety darkening of skin folds associated with insulin resistance

A

acanthosis nigricans

91
Q

A patient with metabolic syndrome may have PCOS, what symptoms might you see?

A

constellation of infertility, menstrual irregularities, obesity, and hirsutism

92
Q

What is the treatment of metabolic syndrome?

A

diet
physical activity
anti-obesity drugs, bariatric surgery, support groups
dyslipidemia
HTN
hyperglycemia

93
Q
A

Endocrinology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions