Pathology of Diabetes

Question 1

Islets of Langerhan are found where

Answer 1

endocrine pancreas

Question 2

2/3 of islet cells in pancreas are

Answer 2

B cells

Question 3

which cells in pancreas secrete insulin

Answer 3

B cells

Question 4

insulin is secreted into blood via

Answer 4

capillaries

Question 5

Insulin binds to what and drives glucose into adipocytes

Answer 5

receptor

Question 6

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

Answer 6

decrease

Question 7

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

Answer 7

HLA Molecules

Question 8

lymphocyte infiltration of islets (insulitis) leads to

Answer 8

destruction of B cells

Question 9

What does destruction of B cells do to insulin

Answer 9

Decreases it

Question 10

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

Answer 10

rises glucose

Question 11

Aetiology of type 2 diabetes (2)

Answer 11

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

Question 12

What happens in the environment in terms of obesity in diabetes

Answer 12

Expanded upper body visceral fat mass (pot belly)

Question 13

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

Answer 13

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

Question 14

What releases fatty acids in diabetes

Answer 14

Adipocytes

Question 15

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

Answer 15

decreased insulin receptor sensitivity

Question 16

Increased Free fatty acids in blood leads to what regarding insulin

Answer 16

decreased Insulin receptor sensitivity to insulin

Question 17

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

Answer 17

Pancreas needs to secrete more insulin

Question 18

Increased free fatty acids in blood in diabetes leads to

Answer 18

decreased insulin receptor sensitivity to insulin

Question 19

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

Answer 19

decreased removal of glucose from blood

Question 20

Decreased insulin receptor sensitivity to insulin leads to

Answer 20

decreased removal of glucose from blood, rise glucose and insulin

Question 21

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

Answer 21

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

Question 22

central adiposity leads to

Answer 22

hyperinsulinaemia

Question 23

Are people diabetic in Central Adiposity

Answer 23

Not yet

Question 24

Central Adiposity causes what to happen to insulin

Answer 24

Increase

Question 25

expanded upper body visceral fat mass leads to

Answer 25

peripheral insulin resistance

Question 26

No diabetes will occur if can do what to insulin

Answer 26

Increase it substantially

Question 27

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

Answer 27

Need pancreas that produces more and more insulin

Question 28

Which genes control insulin secretion in pancreas? If gene is a variant it may promote insulin production at

Answer 28

low levels but not high levels

Question 29

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

Answer 29

cannot produce large amounts of insulin

Question 30

In a normal person what happens to glucose when insulin rises

Answer 30

It decreases

Question 31

In type 1 diabetes what happens to glucose when insulin decreases

Answer 31

It rises

Question 32

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

Answer 32

decrease glucose which is normal

Question 33

In type 2 diabetes insulin secretion what happens to insulin secretion

Answer 33

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

Question 34

What genes involved in Type 2 Diabetes

Answer 34

Not HLA Genes | Not Adiposity Genes

Question 35

What unmasks Type 2 Diabetes in genes

Answer 35

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

Question 36

Which part of Type 2 Diabetes pathology is reversible

Answer 36

Central Adiposity

Question 37

Diabetes decreases life expectancy by

Answer 37

5-10 years

Question 38

Commonest cause of death in Diabetes

Answer 38

Myocardial Infarction

Question 39

What does Diabetes accelerate

Answer 39

Atherosclerosis

Question 40

How is atherosclerosis accelerated (2)

Answer 40

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

Question 41

Hyperlipidaemia can lead to

Answer 41

Atherosclerosis

Question 42

Microvascular disease in diabetes affects which vessels

Answer 42

arterioles

Question 43

What surrounds basal lamina

Answer 43

smooth muscle cells

Question 44

what happens to basal lamina in diabetes

Answer 44

becomes thick

Question 45

arteriolar disease is also called

Answer 45

hyaline change

Question 46

what happens in small vessel disease and glycosylation

Answer 46

increased connective tissue around capillaries

Question 47

Collagen is said to be what

Answer 47

glycosylated

Question 48

Collagen is related to basal lamina how

Answer 48

It is in normal basal lamina

Question 49

Normal collagen does not bind

Answer 49

albumin

Question 50

What happens to albumin in sub endothelial space of arterioles

Answer 50

no accumulation

Question 51

Glycosylated collagen does bind

Answer 51

Albumin

Question 52

Glycosylated Collagen leads to what happening to Albumin

Answer 52

accumulation of albumin in sub endothelial space of arterioles

Question 53

Rigid Cross Linked Protein in Diabetes what happens to it?

Answer 53

It cannot easily be removed

Question 54

What two things does Glycosylation lead to

Answer 54

Accumulation of trapped plasma proteins + | Accumulation of cross-linked basal lamina proteins