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D2 Fall > Gen Path Exam 2 - Pathology of Diabetes > Flashcards

Gen Path Exam 2 - Pathology of Diabetes Flashcards

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1
Q

Syndrome with disordered carbohydrate metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combo of insulin resistance and inadequate insulin secretion to compensate

A

Diabetes mellitus

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2
Q

Diabetes mellitus affects what % of the US?

A

10%

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3
Q

In the US, ____ million new cases of diabetes are diagnosed each year and ____ million have
prediabetes

A

1.2; 86

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4
Q

How many Americans currently have diabetes?

A

30 million

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5
Q

How many Americans will have diabetes in 2050?

A

1 in 3

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6
Q

What is the incidence rate for diabetes in people age 20-44? What about 65-74?

A

20-44 years old = 2%
65-74 years old = 18%

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7
Q

Leading cause of end-stage renal disease, adult-onset blindness, and nontraumatic lower extremity amputations resulting from atherosclerosis of arteries

A

Diabetes

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8
Q

Why were the terms “insulin-dependent diabetes mellitus” and “non-insulin-dependent diabetes mellitus” eliminated by the American Diabetes Association?

A

Bc they are based on pharmacologic rather than etiologic considerations

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9
Q

Due to pancreatic islet beta cell destruction predominantly by an autoimmune process, and these pts are prone to ketoacidosis

A

Type 1 diabetes mellitus

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10
Q

Most prevalent form of diabetes mellitus

A

Type 2 diabetes mellitus

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11
Q

Due to insulin resistance, mainly caused by visceral obesity, with a defect in compensatory insulin secretion

A

Type 2 diabetes mellitus

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12
Q

Used to be termed juvenile-onset diabetes mellitus, or ketosis-prone diabetes mellitus, or insulin-dependent diabetes mellitus

A

Type 1 diabetes mellitus

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13
Q

Used to be termed adult-onset diabetes mellitus,
ketoacidosis-resistant diabetes mellitus or non-insulin-dependent diabetes mellitus

A

Type 2 diabetes mellitus

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14
Q

Known as latent autoimmune diabetes in adults

A

Type 1.5 diabetes

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15
Q

Autoimmune diabetes that begins in adulthood and does not need insulin for glycemic control at least in the first 6 months after diagnosis

A

Type 1.5 diabetes

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16
Q

Shares genetic, immunologic, and metabolic features with both Type 1 and Type 2 diabetes mellitus

A

Type 1.5 diabetes

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17
Q

Some consider it to be a slowly progressive form of Type 1 diabetes mellitus, while others consider it a separate distinct form of diabetes

A

Type 1.5 diabetes

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18
Q

Refers to disorders due to monogenic defects in beta-cell function, with little or no defect in insulin action that was observed in non-obese children, adolescents, and young adults

A

Maturity-onset diabetes of the young

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19
Q

Characterized by carbohydrate intolerance during pregnancy usually resolving after delivery

A

Gestational diabetes mellitus

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20
Q

Diabetes that develop secondary to some other identifiable etiology or acquired disease

A

Secondary diabetes

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21
Q

Pt has hyperglycemia with little or no endogenous insulin secretion

A

Type 1 diabetes mellitus

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22
Q

Onset of disease is abrupt with marked polyuria, polydipsia, polyphagia, weight loss, fatigue

A

Type 1 diabetes mellitus

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23
Q

Highly prone to ketosis; pts frequently present for tx in an intial episode of diabetic ketoacidosis

A

Type 1 diabetes mellitus

24
Q

Marked sensitivity/brittleness to exogenous insulin administration, particularly with regular insulin

A

Type 1 diabetes mellitus

25
Q

In Type 1 diabetes mellitus, a prodromal phase of polyuria, polydispia, and weight loss may precede the development of what?

A

Diabetic ketoacidosis

26
Q

Type 1 diabetes mellitus accounts for what % of diagnosed diabetes cases?

A

5-10%

27
Q

Type 1 diabetes mellitus incidence most commonly peaks during what times in a person’s life?

A

Middle of first decade
Time of growth acceleration of adolescence

28
Q

Pts maintain some endogenous insulin secretory capability by pancreatic beta-cells despite the overt abnormalities of glucose homeostasis, including fasting hyperglycemia and/or carbohydrate intolerance

A

Type 2 diabetes mellitus

29
Q

Pts are NOT absolutely dependent on insulin for life

A

Type 2 diabetes mellitus

30
Q

Why are pts with Type 2 diabetes mellitus relatively resistant to development of ketosis in the basal state?

A

They have retention of endogenous insulin secretory capabilities

31
Q

Generally demonstrate marked resistance or insensitivity to the metabolic actions of endogenous as well as exogenous insulin, in part as the result of decreased insulin receptors

A

Type 2 diabetes mellitus

32
Q

Have a failure of postreceptor coupling and of intracellular insulin action that is also a major cause of insulin resistance

A

Type 2 diabetes mellitus

33
Q

Can have a long presymptomatic phase, leading to a 4-7 year delay in diagnosis

A

Type 2 diabetes mellitus

34
Q

Type 2 diabetes mellitus accounts for what % of diagnosed diabetes cases?

A

90%

35
Q

Type 2 diabetes mellitus occurs most commonly in what people?

A

40 years and older

36
Q

The incidence of Type 2 diabetes mellitus is increasing more rapidly in what age groups?

A

Adolescents/young adults

37
Q

Gestational diabetes mellitus develops in what % of pregnancies? What trimester?

A

1-3%; 3rd trimester

38
Q

Females with gestational diabetes mellitus will exhibit an increased risk for what?

A

Perinatal morbidity and mortality
Developing Type 2 diabetes mellitus later in life

39
Q

What can greatly reduce the chance of developing over Type 2 diabetes mellitus after having gestational diabetes during pregnancy?

A

Control of weight after pregnancy

40
Q

What are the causes of secondary diabetes?

A

Genetic defects of Beta cell function
Genetic defects in insulin action
Genetic syndromes
Disease of exocrine pancreas
Drug/chemical induced
Infections

41
Q

In Type 1 diabetes mellitus, what is increased urination (polyuria) a consequence of? What is this secondary to? What is the result?

A

Osmotic diuresis, secondary to sustained hyperglycemia

Result = loss of glucose, water, electrolytes in urine

42
Q

In Type 1 diabetes mellitus, what is increased thirst (polydipsia) a consequence of?

A

Hyperosmolar state

43
Q

In Type 1 diabetes mellitus, what is the initial weight loss due to?

A

Loss of water, glycogen, triglycerides
Reduced muscle mass as AA’s are diverted to form glucose and ketone bodies

44
Q

A common feature of Type 1 diabetes mellitus is _________ _______, despite normal or increased appetite

A

weight loss

45
Q

In Type 1 diabetes mellitus, what is postural hypotension a result of?

A

Decreased plasma volume

46
Q

What is a serious prognostic sign in Type 1 diabetes mellitus?

A

Hypotension in recumbent position

47
Q

What may be present at the time of diagnosis of Type 1 diabetes mellitus, particularly when the onset is subacute?

A

Paresthesias

48
Q

In Type 1 diabetes mellitus, what is paresthesias due to?

A

Temporary dysfunction of peripheral sensory nerves

49
Q

How is temporary dysfunction of peripheral sensory nerves/paresthesia in Type 1 diabetes mellitus usually resolved?

A

Insulin replacement (restores glycemic levels)

50
Q

What does temporary dysfunction of peripheral sensory nerves/paresthesia in Type 1 diabetes mellitus suggest?

A

Neurotoxicity from sustained hyperglycemia

51
Q

Why does blurred vision often develop in Type 1 diabetes mellitus?

A

Lenses/retina exposed to hyperosmolar fluids

52
Q

What does the fruity breath odor of acetone suggest?

A

Diabetic ketoacidosis

53
Q

Why does a patient’s level of consciousness vary depending on the degree of hyperosmolality in Type 1 diabetes mellitus?

A

Minimal = insulin deficiency slowly develops, sufficient water intake maintained

Stupor or coma = vomiting due to ketoacidosis, dehydration progresses, compensatory mechanisms to maintain osmolarity are inadequate

54
Q

What type of weight loss are features of more slowly developing insulin deficiency in Type 1 diabetes mellitus?

A

Loss of subcutaneous fat
Loss of muscle

55
Q
A

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