Pancreas Morphology

Question 1

Reduction in the number and size of islets: more often in DM1/2?

Answer 1

DM1

Question 2

Describe islet morphologic/composition change to islets in DM1

Answer 2

Lymphocytic infiltrates (T-lympho). insulinitis

Question 3

Describe islet morphologic/composition change to islets in DM2

Answer 3

Amyloid deposition within islets. Also part of normal aging process in nondiabetics.

Question 4

When would you see an increase in number and size of islets?

Answer 4

Nondiabetic newborns of diabetic mothers

Question 5

Hallmark for___: accelerated atherosclerosis involving the aorta and large- and medium-sized arteries

Answer 5

Diabetic macrovascular disease

Question 6

Most common cause of death in diabetics is due to

Answer 6

Myocardial infarction (from coronary artery atherosclerosis)

Question 7

Amorphous, hyaline thickening of wall of arterioles, causing lumen narrowing. Is associated with hypertension is more prevalent and more severe in diabetics

Answer 7

Hyaline arteriolosclerosis

Question 8

Diffuse thickening of basement membranes, most evident in the capillaries of the skin, skeletal muscle, retina, renal glomeruli, and renal medulla

Answer 8

Diabetic microangiopathy

Question 9

What is the underlying cause of diabetic nephropathy, retinopathy, and some forms of neuropathy?

Answer 9

Microangiopathy, paradoxically, the capillaries are more leaky than normal to plasma proteins.

Question 10

Define the three most important glomerular lesions in diabetic nephropathy.

Answer 10

Capillary basement membrane thickening, diffuse mesangial sclerosis, and nodular glomerulosclerosis

Question 11

Three lesions are present in what?
– Glomerular lesions
– Renal vascular lesions, principally arteriolosclerosis
– Pyelonephritis, including necrotizing papillitis

Answer 11

Diabetic nephropathy

Question 12

What is this?

• This occurs in the Glomerular capillary basement membrane (GBM) occurs in virtually all diabetic nephropathy – Can only be seen by electron microscopy
• Thickening begins as early as 2 years after the onset of type 1 diabetes and progresses
• Also thickening of the tubular basement membranes

Answer 12

Capillary Basement Membrane Thickening

Question 13

What is this?
- Mesangial increase is typically associated with the overall thickening of the GBM in diabetic nephropathy
• As the disease progresses → nodular (glomerulosclerosis)

Answer 13

Diffuse Mesangial Sclerosis

Question 14

Matrix depositions in Diffuse Mesangial Sclerosis and nodules in Nodular glomerulosclerosis are ___ positive

Answer 14

PAS

Question 15

In Diffuse Mesangial Sclerosis, progressive expansion of mesangium correlates with what?

Answer 15

deteriorating renal function (see proteinuria)

Question 16

A.k.a: Intercapillary glomerulosclerosis or Kimmelstiel-Wilson dis-ease
• Nodules of matrix (PAS- positive) situated in the periphery of the glomerulus. Lesions can be patchy
• As it progresses: DMS nodules enlarge and eventually obliterate the glomerular tuft

Answer 16

Nodular glomerulosclerosis

Question 17

nodular lesions are frequently accompanied by prominent accumulations of hyaline material in capillary loops (“FIBRIN CAPS”) are indicative of what disease?

Answer 17

In nodular glomerulosclerosis

Question 18

nodular lesions are frequently accompanied by prominent accumulations of hyaline material adherent to Bowman capsules (“CAPSULAR DROPS”), indicative of what disease?

Answer 18

In nodular glomerulosclerosis

Question 19

Renal atherosclerosis and arteriolosclerosis constitue part of what disease in diabetics?

Answer 19

macrovascualr

Question 20

What is the term for a special pattern of acute inflammation of the kidneys that is much more common in diabetics?

Answer 20

Necrotizing papillitis (form of acute pyelonephritis)

see it, then prob have DM

Question 21

Name three diabetic ocular complications

Answer 21

• Cataract
• Glaucoma
• Retinopathy

Question 22

• Solitary and usually small (often

Answer 22

Insulinoma