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Systems 2nd Year: Endocrine > Pathology of Diabetes > Flashcards

Pathology of Diabetes Flashcards

1
Q

Islets of Langerhan are found where

A

endocrine pancreas

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2
Q

2/3 of islet cells in pancreas are

A

B cells

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3
Q

which cells in pancreas secrete insulin

A

B cells

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4
Q

insulin is secreted into blood via

A

capillaries

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5
Q

Insulin binds to what and drives glucose into adipocytes

A

receptor

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6
Q

When glucose is taken up by cells what happens to glucose in serum

A

decrease

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7
Q

Molecules that help T cells recognise self from non-self?

A

HLA Molecules

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8
Q

lymphocyte infiltration of islets (insulitis) leads to

A

destruction of B cells

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9
Q

What does destruction of B cells do to insulin

A

Decreases it

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10
Q

What does destruction of B cells and destruction of insulin do to glucose

A

rises glucose

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11
Q

Aetiology of type 2 diabetes (2)

A

reduced tissue sensitivity to insulin and inability to secrete very high levels of insulin

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12
Q

What happens in the environment in terms of obesity in diabetes

A

Expanded upper body visceral fat mass (pot belly)

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13
Q

Expanded upper body visceral fat mass (pot belly) results in

A

increased free fatty acids in blood (Note - patient is not yet diabetic)

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14
Q

What releases fatty acids in diabetes

A

Adipocytes

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15
Q

Expanded upper body visceral fat mass leads to increased free fatty acids which leads to

A

decreased insulin receptor sensitivity

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16
Q

Increased Free fatty acids in blood leads to what regarding insulin

A

decreased Insulin receptor sensitivity to insulin

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17
Q

In a person with central adiposity what does pancreas need to do to move glucose into cells

A

Pancreas needs to secrete more insulin

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18
Q

Increased free fatty acids in blood in diabetes leads to

A

decreased insulin receptor sensitivity to insulin

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19
Q

Expanded upper body visceral fat mass leads to decreased insulin receptor sensitivity which then causes

A

decreased removal of glucose from blood

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20
Q

Decreased insulin receptor sensitivity to insulin leads to

A

decreased removal of glucose from blood, rise glucose and insulin

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21
Q

Decreased removal of glucose from blood leads to raised glucose what happens to insulin levels

A

insulin levels then have to markedly increase to make glucose go back to normal levels

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22
Q

central adiposity leads to

A

hyperinsulinaemia

23
Q

Are people diabetic in Central Adiposity

A

Not yet

24
Q

Central Adiposity causes what to happen to insulin

A

Increase

25
Q

expanded upper body visceral fat mass leads to

A

peripheral insulin resistance

26
Q

No diabetes will occur if can do what to insulin

A

Increase it substantially

27
Q

If peripheral insulin resistanceis present how do we keep glucose levels normal?

A

Need pancreas that produces more and more insulin

28
Q

Which genes control insulin secretion in pancreas?

If gene is a variant it may promote insulin production at

A

low levels but not high levels

29
Q

If a patient has many gene variants for low insulin secretion what happens

A

cannot produce large amounts of insulin

30
Q

In a normal person what happens to glucose when insulin rises

A

It decreases

31
Q

In type 1 diabetes what happens to glucose when insulin decreases

A

It rises

32
Q

In central adiposity with normal gene for high end insulin secretion what happens when insulin increases

A

decrease glucose which is normal

33
Q

In type 2 diabetes insulin secretion what happens to insulin secretion

A

does not increase enough to counteract insulin resistance caused by central adiposity

34
Q

What genes involved in Type 2 Diabetes

A

Not HLA Genes

Not Adiposity Genes

35
Q

What unmasks Type 2 Diabetes in genes

A

A multiple gene defect of pancreatic B cell insulin production which is unmasked by central adiposity

36
Q

Which part of Type 2 Diabetes pathology is reversible

A

Central Adiposity

37
Q

Diabetes decreases life expectancy by

A

5-10 years

38
Q

Commonest cause of death in Diabetes

A

Myocardial Infarction

39
Q

What does Diabetes accelerate

A

Atherosclerosis

40
Q

How is atherosclerosis accelerated (2)

A

Glucoses attach to low density lipoprotein

Low density lipoprotein is not removed by liver cells leads to lipoprotein and lipid stay in blood leads to Hyperlipidaemia

41
Q

Hyperlipidaemia can lead to

A

Atherosclerosis

42
Q

Microvascular disease in diabetes affects which vessels

A

arterioles

43
Q

What surrounds basal lamina

A

smooth muscle cells

44
Q

what happens to basal lamina in diabetes

A

becomes thick

45
Q

arteriolar disease is also called

A

hyaline change

46
Q

what happens in small vessel disease and glycosylation

A

increased connective tissue around capillaries

47
Q

Collagen is said to be what

A

glycosylated

48
Q

Collagen is related to basal lamina how

A

It is in normal basal lamina

49
Q

Normal collagen does not bind

A

albumin

50
Q

What happens to albumin in sub endothelial space of arterioles

A

no accumulation

51
Q

Glycosylated collagen does bind

A

Albumin

52
Q

Glycosylated Collagen leads to what happening to Albumin

A

accumulation of albumin in sub endothelial space of arterioles

53
Q

Rigid Cross Linked Protein in Diabetes what happens to it?

A

It cannot easily be removed

54
Q

What two things does Glycosylation lead to

A

Accumulation of trapped plasma proteins +

Accumulation of cross-linked basal lamina proteins

Systems 2nd Year: Endocrine (52 decks)

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