patho case 2 (1105-1120)

Question 1

what feature does DM metabolic disorders share

Answer 1

hyperglycemia

Question 2

what is the leading cause of end-state renal disease, adult-onset blindness and non-traumatic lower extremity amputations resulting from atherosclerosis of the arteries

Answer 2

diabetes

Question 3

what is the level for a diagnosis of diabetes for pasting plasma glucose

Answer 3

greater than 126 mg/dL

Question 4

what is the autoimmune disease characterized by pancreatic beta cell destruction and an absolute deficiency of insulin

Answer 4

type 1 diabetes

Question 5

what is type 2 diabetes caused by

Answer 5

combination of peripheral resistance to insulin action and an inadequate secretory response by the pancreatic beta cells

Question 6

what levels serve as a surrogate for beta cell function

Answer 6

C-peptide levels

Question 7

what is the most important stimulus for insulin synthesis and release

Answer 7

glucose itself

Question 8

what secretes GIP

Answer 8

enteroendocrine K cells in the proximal small bowel

Question 9

what secretes GLP-1

Answer 9

L cells in the distal ileum and colon

Question 10

what is the most potent anabolic hormone

Answer 10

insulin

Question 11

what subunit of insulin possess tyrosine kinase activity

Answer 11

beta subunit cytosolic domain

Question 12

what locus is most important for DM type 1

Answer 12

HLA gene cluster on chromosome 6p21

Question 13

what is the fundamental immune abnormality in type 1 diabetes

Answer 13

failure of self-tolerance in T cells specific for islet antigens

Question 14

what is the most important environmental risk factor for type 2 diabetes

Answer 14

obesity

Question 15

what are the 2 cardinal metabolic defects that characterized type 2 diabetes

Answer 15

insulin resistance and beta-cell dysfunction

Question 16

what is insulin resistance

Answer 16

the failure of target tissues to respond normally to insulin

Question 17

when is the diagnosis of type 2 diabetes most frequently made

Answer 17

after routine blood testing in asymptomatic persons

Question 18

what triad is the onset of type 1 diabetes usually marked by

Answer 18

triad of polyuria, polydipsia and polyphagia

Question 19

what effect does epinephrine have on insulin and glucagon

Answer 19

blocks any residual insulin action and stimulates the secretion of glucagon

Question 20

what is the second major effect of insulin deficiency

Answer 20

activation of the ketogenic machinery

Question 21

what happens when the urinary excretion of ketones is compromised by dehydration

Answer 21

systemic metabolic ketoacidosis

Question 22

what is the most common acute metabolic complication in either type of diabetes

Answer 22

hypoglycemia

Question 23

what seems to be responsible for the long-term complications of diabetes

Answer 23

persistent hyperglycemia

Question 24

what lesions are encountered with diabetic nephropathy

Answer 24

glomerular lesions, renal vascular lesions, pyelonephritis