Exam 2 pre lecture Flashcards

1
Q

what is polyuria

A

frequent urination

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2
Q

polydipsia meaning

A

excessive thirst

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3
Q

what is polyphagia

A

lack of weight gain and feeling hungry

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4
Q

WHat are the 3 cardinal signs of diabetes

A

polyuria, polydipsia, polyphagia

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5
Q

What is the mechanism leading to the 3 polys

A

high BG leads to glucose in urine.
This leads to excessive water loss (polyuria) leading to dehydration and polydipsia.
Inability to utilize glucose as fuel lowers BW and leads to excessive hunger

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6
Q

what is the criteria for diagnosis of diabetes

A

A1C > or = 6.5% or fasting plasma glucose (FPG) > or = 126

2-H plasma glucose of >200
random plasma glucose >200

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7
Q

Type 1 diabetes is also known as

A

Insulin dependent diabetes mellitus (IDDM)

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8
Q

What percent of people have type I DM

A

10%

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9
Q

insulin secretion in Type I DM

A

no functional insulin secretion due to near complete loss of pancreatic B cells

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10
Q

Type I DM may cause ________

A

ketoacidosis

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11
Q

Why does T 1 DM lead to ketoacidosis

A

We use fatty acids for fuel leading to the production of ketoacids

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12
Q

Age onset of T I DM

A

early

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13
Q

what is T I DM

A

an autoimmune response that specifically targets pancreatic B cells

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14
Q

FH for T 1 DM

A

often negative family history

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15
Q

What are the two antibodies that suggest an immune response against pancreatic B cells

A

ICA- islet cell cytoplasmic antibodies
IAA- Insulin antibodies

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16
Q

how does T 1 DM appear as person ages

A

Early on, they have 100% BCM (Beta cell mass) and are ICA and IAA negative. presence if ICA and IAA suggest immune response to pancreatic B cell. loss of BCM is gradual and fasting blood glucose (FBG) is normal until 70% of BCM is lost.

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17
Q

what is OGTT, what is it used for?

A

Oral glucose tolerance test, we give large bolus of glucose and BG is measured. SHows hyperglycemia if BCM does not have enough insulin to bring it down.

18
Q

What is C-peptide

A

It indicates the presence of functioning B cell mass. It is a marker for insulin secretion even if they are receiving exogenous insulin

No c-peptide= no BCM left

19
Q

sensitivity vs selectivity difference

A

sensitivity- if someone does not have type I DM, but have IA-2 they have a 57% chance of developing it

selectivity- 99% of T 1 DM have antibodies against IA-2

20
Q

T 2 diabetes % of diabetic population

21
Q

T 2 DM is also known as_________ and can be classified into _______ and ________

A

non-insulin dependent diabetes mellitus

can be classified into obese and non-obese

22
Q

percentage of obese T 2 DM pts

A

80%- obese, 10% non-obese

23
Q

non obese T 2 DM is often referred to as

A

MODY (maturity onset diabetes of young)

24
Q

Why is T2 DM referred to as MODY

A

age of onset is below 25

25
age of onset of obese T 2 DM
usually over 35
26
Which one is positive for FH, T1 or T2
T2
27
Insulin secretion in T1 vs T2
T1 has no secretion while T2 has low secretion
28
what aspect of obese T 2 diabetics leads to loss of B cell mass
Obese T 2 diabetics show insulin resistance, this leads to overproduction of insulin stressing B cell. Leads to loss of B cell mass.
29
What are the 4 consequences of lack of insulin
Hyperglycemia- glucosuria hyperlipidemia uninhibited glucagon secretion-
30
How does a lack of insulin affect glycogen synthesis
decreases it
31
how does a lack of insulin affect gluconeogenesis
insulin inhibits gluconeogenesis. A lack causes aa conversion into glucose
32
how does a lack of insulin lead to hyperlipidemia
causes increased fat mobilization from fat cells. Also increased fat oxidation (leads to ketoacidosis sue to accumulation of ketone bodies)
33
relationship between insulin and glucagon
glucagon is opposite of insulin. Insulin inhibits glucagon.
34
prolonged hyperglycemia complications
Cardiovascular neuropathy nephropathy ocular increased susceptibility to infections
35
what are some CV complications hyperglycemia could cause
Micro and macro angiopathy (damage to large and small BV)
36
what are some neuropathies hyperglycemia could cause
accumulation of glucose in nerves are then reduced by aldose reductase to sugar alcohol. This leads to reduced protection from oxidative damage and H20 accumulation in neurons
37
What are some nephropathies caused by hyperglycemia
Changes in renal vasculature and to glomerular basement membrane
38
What are some ocular complications that could be caused by hyperglycemia
Cataracts, retinal microaneurism
39
Insulin therapy goals in diabetics
keep avg glucose below 150. fasting-70-110 pre-meal- 80-130 peak food- less than 180
40
ideal A1c vs A1c for diabetic pt
ideal 6 or below diabetic 7 or below
41
Why is A1c a goof measure
It is considered a good average of total glucose levels because it is a sum total of the exposure of erythrocytes to glucose concentration in blood stream
42