Tutorial 3: Mr R Flashcards
What is the fundamental cause of T1DM from an endocrine stand point?
Autoimmune Disease
Beta Cells in pancreas stops producing insulin as they’re destroyed. Causes glucose absoprtion to decrease
What method is used for confirming DM ? (T1DM)
Blood tests
Fasting blood glucose
Oral glucose test
Type 1 Increase in
ICA - islet cell cytoplasmic autoantibodies
IAA - insulin autoantibodies
What are the differences in type 1 to type 2 DM? Regarding: Endogenous Insulin production: Onset speed: Age of onset: Percent of Population: Body Habitus: Treatment:
TYPE ONE
Endogenous Insulin production: minimal/ none
Onset speed: months to years
Age of onset: younger <20
Percent of Population: 5-15%
Body Habitus: thin, lean decreases MBI
Treatment: High protein diet, insulin treatment, exercise
TYPE TWO Endogenous Insulin production: normal Onset speed: years Age of onset: older > 20 Percent of Population: 85-95% Body Habitus: overweight/ obese Treatment: lifestyle
What hyperglycaemic “polys” is DM often associated with?
Polyuria - frequent urination
Polydipsia - intense thirst
Polyphagia - increased apetite
How do you calculate 24 hour urine sample
E.g.
2000mL
= 2000ml/ weight/ 24 (hours)
What consequences are there from hypERglycaemia on the body?
No insulin, therefore decreased glucose uptake + increases protein catabolsim = increased plasma AA, nitrogen loss = hyperglycaemia
Hyperglycaemia = increased electrolyte depletion = ketogenesis = dehydration = coma = death
What consequences are there from hypOglycaemia on the body?
Inhibition of insulin secretion, glycogen, growth hormone secretion, cortisol, cognitive function. Lethargy + coma at 2.2 mmol/L glucose
Brain damage + death at 1.1 mmol/L glucose
Chronic DM is often associated with certain “pathies” define these?
Neuropathy - disease/dysfunction of peripheral nerves = numbness/ weakness
Nephropathy - damage to the nephrons
Retinopathy - disease of retina = visual impairment
Define
RBF
ERPF
GFR
Renal Blood Flow = volume blood delivered to kidneys per unit of time
Effective Renal Plasma Flow = plasma flowing through kidneys
Glomerular Filtration Rate= amount of blood filtered by kidney every minute
What is the physiological principle of the inulin clearnace test to measure GFR?
Freely filtered and none of the insulin is reabsorped or secreted back
How do you calculate GFR?
Hint use Renal Clearnace Formula
C = (U x V) / P
e.g
V = UFR = 1.5 mL/min
P = PI = 0.55mg/mL
U = UI = 42 mg/mL
(42 x 1.5) / 0.55 = 115
===
(UI x U) / PI
What is hyponetremia?
Low Na+
What is hyperkalemia?
high K+
secreted by kidneys in distal tubules
What is hyperphosphatemia?
high PO4
High serum phosphate levels
Kidneys failing cant get rid of phosphate
What is uremia?
high urea
What is hypocapnic?
Low pCO2
What is hypocalcemia?
low calcium
What is hyperalbuminemia?
high albumin
What is ketoneuria?
Ketones in blood
What is presence of blood in urine called?
Hematuria
Why could someone have hypertension even on medication?
Progessive renal failure, kindey thinks low renal blood flow & Na rentention = makes it increase ECF = increase CO = hypertension
What is anemia?
Deficiency of haemoglobin in blood
= eurethropetein produce less RBC
Why would someone fracture easier with vitamin D and calcium?
Low Vitamin D = helps absorb calcium in kidneys. Therefore, kidneys arent functioning = low absorption of calcium
What is haemodialysis?
External blood filtration via dialysis machine for those whose kidneys dont usually function
What advice can you give with someone for treatment?
diet control
exercise
glycaemic control
medication control
How do you tell if metabolic or respiratory compensation
If PaCO2 is abnormal and pH is normal = compensation
pH > 7.4 = compensated alkalosis
pH < 7.4 = compensated acidosis
