Final Study Guide Flashcards
4 Types of cells found in pancreas
- Alpha Cells
- Beta Cells
- Delta Cells
- F or PP cells
What Alpha Cells Release
Produce glucagon
Stimulated by hypoglycemia
What Beta cells release
produce insulin
when high blood glucose
What delta cells release
- peptide hormones somatostatin
- inhibit release of glucagon and insulin
What F or PP cells release
Secrete pancreatic polypeptide hormone (appetite)
Type I Typical Characteristics
- Juvenile
- insulin-dependent DM, from beta cell destruction leading to an absolute insulin deficiency
- 5-10%
- Sudden onset
- mostly in children
- thin/normal body
- ketoacidosis
- autoantibodies
- low endogenous insulin
Type II Typical Characteristics
- Adult onset
- non insulin dependent
- from progressive insulin secretory defect on background of insulin resistance
- 90-95% of pop
- gradual onset
- mostly adults
- obese
- RARE ketoacidosis
- NO autoantibodies
- Normal endogenous insulin
Late autoimmune diabetes in adults
- Slow onset Type 1
- some disease-associated autoantibodies
- NO insulin requirement at time of diagnosis
Type 1 DM Pathologic Process
Beta cell destruction which can’t make insulin
Type 2 DM Pathologic Process
Cellular resistance to insulin
- increase with obesity
- insulin resistance hyperinsulineamia impaired glucose tolerance
- impaired fasting glucose-hypoglycemia-EARLY DM-beta cell failure and requires insulin like type 1
- Decreased beta cell responsiveness to plasma glucose levels, abnormal glucagon secretion, islet dysfunction-decreased beta cell mass, abnormal beta function, alterations in the insulin receptor of muscle liver and adipose
- Amyloid formation in pancreas with islet cell destruction
Classic symptoms of Type 1 DM
Lethargy stupor breath smell acetone weight loss Kussmaul breathing (hyperventilation) nausea vomit abdominal pain
Classic symptoms of DM
Polydipsia plyphagia blurred vision polyuria glycosuria paresthesias recurrent infection
Acute complications of DM
-Hypoglycemia pallor tremor balance fatigue confused dizzy
Diabetic Ketoacidosis Symptoms
Decreased insulin
more stress hormones
more glucose production
more ketones=odor
Chronic DM Symptoms
Microvascular disease -neuropathy -retinopathy -nephropathy Macrovascular disease -atherosclerosis -CAD -Stroke -PVD
Cardiovascular disease nephropathy retinopathy neuropathic ulcer Decrease awareness decrease blood for healing increased glucose in body fluid decreased WBCs poor function of WBC
Tri-Neuropathy
- Sensory
- Motor
- Autonomic
Sensory Neuropathy Loss
Cannot sense
Type 2: stocking glove
Type 1: Small nerve fibers
Motor neuropathy
Loss intrinsics foot muscles claw toe deformity high peak pressure no ankle her reflex Type 1: large nerve fiber damage
Autonomic Neuropathy
Nonelastic
Dry skin
No sweat or oil production
Type 1: large nerve fibers and sympathetic ganglion
Neuropathic Ulcer
Plantar surface toes bony prominence pale pink or red periwound callus/hyperkeratotic minimal drainage round may not have pain pulse may be normal diminished or bounding infection
How advanced glycated end products are formed
Chronic complication of DM which his result from attachment of glucose metabolites onto proteins
results in irreversible cross links with collagen
Consequences of overproduction of glycated endproducts
Inelasticicty of ROM deficits in foot, high peak pressure, gait abnormalities
-Can lead to nephropathy
Stage of Inflammation: Hemostasis
Time: 30min
Fibrin formation–lysed by PLASMIN
Endothelial cells release PROSTACYCLIN (arteriole vasodilator to bring healing cells)
Stage of Inflammation:
Inflammation
Time: 3-7day
Invasive of neurophils that lyse nonviable cell components
Platelets and Neutrophils release Growth Factors,
Eosinophils phagocytose devitalized tissue
Mast cells and Basophils–release histamine (increases vascular permeability and attract Monocytes)
Monocytes–>macrophages
Lymphocytes produce Antibodies for immune response
