pathophys diabetes

Question 2

Amadori reactionglucose–>_______–>ketoamine–>AGEswhat does AGE stand for?

Answer 2

Schiff basestep1 is rapid and reversiblestep 2 is slow and irreversibleAGE : advanced glycation end products

Question 3

Sorbitol pathway: where does it occur?glucose–>sorbitol–>______ ↑[glucose] ↑ this minor pathway by a mass action effect. accumulate –> osmotic disturbances.

Answer 3

1. liver (+other tissues)2. fructoseoutside liver, e.g. nerves, the osmotic effects –>cell damage, neuropathy, although other factors -protein glycation play a role.can cause distortion of the lens, visual problems

Question 4

glycation of proteins : lysine–> Schiff’s baseLDLs may become cross-linked to proteins in the ECM of __wall, then recognised by receptors :___on macrophages–>____

Answer 4

arterial RAGE atherosclerosis

Question 5

superoxide dismutase affected by enzyme glycationdecreased activity so ___ _____ are not converted–> h2o2–>water

Answer 5

free radicals

Question 6

Cardiovascular disease1. Activation of Factor VII (due to ↑VLDL)2. Impaired endothelial function –>↓___ ___. –>vasoconstriction +reduced blood flow.3. Macrophages : RAGE)–> uptake +accumulation of glycated __–> ___plaque.

Answer 6

nitric oxideLDL, atherosclerotic

Question 7

CVD4. Proliferation of smooth muscle - part of development of atherosclerosis –> activation of____ and release of___

Answer 7

macrophages . chemokines and growth factors

Question 8

NephropathyGlomerular ___ ____ becomesnodular (Kimmelstiel-Wilson nodules) –>allowing albumin toappear in the urine (microalbuminuria).

Answer 8

basement membrane

Question 9

Osteoarthritismodification of ___and other structural proteins –> not readily degraded. ↓ turnover can –>more radical induced damage to these proteins

Answer 9

collagen