MedComplex-Endocrine1 (DM) Flashcards
What are the three types of cells located in the ISLETS OF LANGERHANS? And what do each of them produce?
1.Alpha cells(20%)-glucagon 2. Beta cells (70%)-insulin 3.Delta cells (10%)-SomatoStatin
DM: A functional insufficiency of the tissue caused by destruction of the islets or a selective loss of ____ cells, results in Diabetes. It is a consequence of either 1: absolute or partial ______ deficiency, or 2: an abnormal response of ________ to Insulin.
BETA..insulin..target tissues
DM: There are complex disturbances of carbohydrate, lipid, and protein metabolism, and a variety of organic changes primarily from ________ pathology.
blood vessel
_______ diabetes includes Type I Diabetes, and Type II Diabetes.
PRIMARY
Type II DM is the most common form of primary diabetes, accounting for more than ___% of all cases.
90%
________ diabetes: The form of Diabetes that can be traced to some OTHER documented disease, such as chronic ________ or disturbances of carbohydrate and lipid metabolism.
secondary… pancreatitis
How do Acromegaly, Cushing’s, and Pehochormocytoma all contribute to DM?
Acromegaly = GH, Cushing’s = ACTH, and Phecochromo = Epi…ALL of these hormones are ANTI-INSULIN
Insulin plays a CRUCIAL role in the intermediary metabolism of what THREE biochemical fuels?
Carbohydrates, lipids, and amino acids
What could be the three reasons for interference with insulin binding to target tissues?
1.Fatty Insulin Receptors 2.Antibodies to insulin 3.Antibodies to insulin receptors
The major stimulus for insulin secretion is _______ (high serum glucose level).
Hyperglycemia
Insulin reduces the level of serum glucose by promoting its influx into the _____, where it is catabolized and transformed into the storage form called Glycogen.
liver
Insulin stimulates the influx of glucose into the ________ cells as well.
striated muscle
Insulin also stimulates the synthesis of ______ from amino acids, mainly in striated muscle, and ____ formation from triglycerides in fat cells (lipogenesis).
PROTEINS…FAT
Excess glucose in the blood spills over into the urine, causing ________. Glucose leads to an osmotic diuresis and causes ______.
glycosuria… polyuria
Anaerobic glycolysis, instead of aerobic respiration, is used for energy production which results in the formation of excessive amounts of ______ acid.
lactic
WHEELHOUSE: Inadequate utilization of fats and reduced lipogenesis (due to lack of insulin) leads to the accumulation of free fatty acids, which are oxidized into ________ and therefore ___________ is the cause of acidosis in advanced diabetes.
Ketones…ketogenesis
What 4 organs are most affected by high circulating glucose? In these tissues, glucose is metabolized to osmotically active compounds (________ and _______). This stimulates the influx of fluids into the affected tissues, and damages the homeostasis of these cells and tissues.
1.Blood Vessels 2.Nerves 3.Lens 4.Kidneys….(sorbitol and fructose)
In the later stages of Type I, the islets show a depletion of beta cells, which are replaced by _______ hyalinized tissue,
fibrous
WHAT ONE WORD TYPIFIES THE PATHOLOGY of DIABETES?
MICROANGIOPATHY (damages the small blood vessels)
Diabetes also accelerates the development of _________, Diabetics are also prone to _______
atherosclerosis….infection
The most prominent changes caused by uncontrolled or inadequately controlled diabetes involve the following systems: 1. ___________, 2._________, 3.________, 4._________
1.Cardiovascular System 2.Renal 3.Eyes 4.Nervous
Kimmelstiel-Wilson Disease is of which organ?
KIDNEY
Diabetes and EYE pathology: Vascular changes may also obstruct the outflow of vitreous causing ________…Diabetes may also cause ________, related to the deposition of (________ and _______) in the lens matrix, causing swelling by OSMOTIC action
Glaucoma…Catacts (sorbitol and fructose)
DM and nerves: Another important complication is _________, which affects the AUTONOMIC and SENSORY nerves, causing symptoms in the extremities.
Peripheral Neuropathy
The peripheral nerve pathology with DM is partially a consequence of diabetic MICROANGIOPATHY and partially related to the deposition of ______ and ______ in the axons and myelin sheaths.
sorbitol and fructose
Clinical Features of DM: The most common symptoms of diabetes are _______ and _______
polyuria and polydipsia (excessive thirst)
Clinical Features of DM: a negative energy balance that results in ________, which is compensated for by an increased _______
muscle wasting…appetite
Clinical Features of DM: Hyperglycemia tends to predispose individuals to _______ and ______ infections.
bacterial and fungal
Clinical Features of DM: Cardiovascular and cerebrovascular changes account for the fact that diabetics have a life span that is shorter (by ___-___ years) than there age-matched peers.
7-9 years
