Pancreas Pathology - CHRONIC Complications of DM

Question 1

List three of the most common macrovascular complications in long standing diabetics

Answer 1

Myocardial infarction, renal vascular insufficiency, and cerebrovascular accidents

Question 2

PAI-1 - function and increased/decreased in DM?

Answer 2

Increased. Functions as an inhibitor of fibrinolysis (and thus acts as a procoagulant) → formation of atherosclerotic plaques.

Question 3

Native Americans,

Hispanics, and African Americans with type 2 DM are most at risk for developing what complication?

Answer 3

Diabetic nephropathy

Question 4

First sign of diabetic nephropathy is? What qualifies as low?

Answer 4

Microalbuminuria - low amounts of albumin in the urine (>30 mg/day, but

Question 5

Microalbuminuria is a marker for increased ___ ___ in DM1/2

Answer 5

cardiovascular mortality.

Question 6

A person with uncontrolled DM1/2 for 10-15 years presents with HTN. Be wary of development of what?

Answer 6

Overt nephropathy with macroalbuminuria (>300 mg of urinary albumin per day).
Many will develop ESRD over 20 years.

Question 7

What is the most frequent pattern of involvement in diabetic neuropathy?

Answer 7

Distal symmetric polyneuropathy of the lower extremities.

– Both motor and sensory function

Question 8

What is this in a chronic, untx diabetic? bowel, bladder, and
sometimes erectile dysfunction

Answer 8

Autonomic neuropathy

Question 9

What is this in a chronic, untx diabetic? sudden footdrop, wristdrop, or isolated cranial nerve palsies

Answer 9

Mononeuropathy

Question 10

Why does diabetic retinopathy/visual impairment occur?

Answer 10

from neovascularization from hypoxia-induced overexpression of VEGF in the retina

Question 11

A trivial infection in the extremity of a diabetic can lead to what?

Answer 11

May lead to gangrene, bacteremia, pneumonia, even death because of increased susceptibility to infections of the skin, tuberculosis, pneumonia, and pyelonephritis.