MedComplex-Endocrine1 (DM)

Question 1

What are the three types of cells located in the ISLETS OF LANGERHANS? And what do each of them produce?

Answer 1

1.Alpha cells(20%)-glucagon 2. Beta cells (70%)-insulin 3.Delta cells (10%)-SomatoStatin

Question 2

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.

Answer 2

BETA..insulin..target tissues

Question 3

DM: There are complex disturbances of carbohydrate, lipid, and protein metabolism, and a variety of organic changes primarily from ________ pathology.

Answer 3

blood vessel

Question 4

_______ diabetes includes Type I Diabetes, and Type II Diabetes.

Answer 4

PRIMARY

Question 5

Type II DM is the most common form of primary diabetes, accounting for more than ___% of all cases.

Answer 5

90%

Question 6

________ diabetes: The form of Diabetes that can be traced to some OTHER documented disease, such as chronic ________ or disturbances of carbohydrate and lipid metabolism.

Answer 6

secondary… pancreatitis

Question 7

How do Acromegaly, Cushing’s, and Pehochormocytoma all contribute to DM?

Answer 7

Acromegaly = GH, Cushing’s = ACTH, and Phecochromo = Epi…ALL of these hormones are ANTI-INSULIN

Question 8

Insulin plays a CRUCIAL role in the intermediary metabolism of what THREE biochemical fuels?

Answer 8

Carbohydrates, lipids, and amino acids

Question 9

What could be the three reasons for interference with insulin binding to target tissues?

Answer 9

1.Fatty Insulin Receptors 2.Antibodies to insulin 3.Antibodies to insulin receptors

Question 10

The major stimulus for insulin secretion is _______ (high serum glucose level).

Answer 10

Hyperglycemia

Question 11

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.

Answer 11

liver

Question 12

Insulin stimulates the influx of glucose into the ________ cells as well.

Answer 12

striated muscle

Question 13

Insulin also stimulates the synthesis of ______ from amino acids, mainly in striated muscle, and ____ formation from triglycerides in fat cells (lipogenesis).

Answer 13

PROTEINS…FAT

Question 14

Excess glucose in the blood spills over into the urine, causing ________. Glucose leads to an osmotic diuresis and causes ______.

Answer 14

glycosuria… polyuria

Question 15

Anaerobic glycolysis, instead of aerobic respiration, is used for energy production which results in the formation of excessive amounts of ______ acid.

Answer 15

lactic

Question 16

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.

Answer 16

Ketones…ketogenesis

Question 17

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.

Answer 17

1.Blood Vessels 2.Nerves 3.Lens 4.Kidneys….(sorbitol and fructose)

Question 18

In the later stages of Type I, the islets show a depletion of beta cells, which are replaced by _______ hyalinized tissue,

Answer 18

fibrous

Question 19

WHAT ONE WORD TYPIFIES THE PATHOLOGY of DIABETES?

Answer 19

MICROANGIOPATHY (damages the small blood vessels)

Question 20

Diabetes also accelerates the development of _________, Diabetics are also prone to _______

Answer 20

atherosclerosis….infection

Question 21

The most prominent changes caused by uncontrolled or inadequately controlled diabetes involve the following systems: 1. ___________, 2._________, 3.________, 4._________

Answer 21

1.Cardiovascular System 2.Renal 3.Eyes 4.Nervous

Question 22

Kimmelstiel-Wilson Disease is of which organ?

Answer 22

KIDNEY

Question 23

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

Answer 23

Glaucoma…Catacts (sorbitol and fructose)

Question 24

DM and nerves: Another important complication is _________, which affects the AUTONOMIC and SENSORY nerves, causing symptoms in the extremities.

Answer 24

Peripheral Neuropathy

Question 25

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.

Answer 25

sorbitol and fructose

Question 26

Clinical Features of DM: The most common symptoms of diabetes are _______ and _______

Answer 26

polyuria and polydipsia (excessive thirst)

Question 27

Clinical Features of DM: a negative energy balance that results in ________, which is compensated for by an increased _______

Answer 27

muscle wasting…appetite

Question 28

Clinical Features of DM: Hyperglycemia tends to predispose individuals to _______ and ______ infections.

Answer 28

bacterial and fungal

Question 29

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.

Answer 29

7-9 years