wk 4 - Diabetes Mellitus Flashcards
Failure to take food after insulin can cause similar effect to:
a) An overdose of glucagon
b) An overdose of insulin
c) An overdose of hyperglycaemic drug
b) An overdose of insulin
The following are the types of blood glucose test that could be measured using the Glucometer EXCEPT:
a) Fasting
b) HbA1C
c) OGTT
d) Random
b) HbA1C
The formation of glycogen from glucose is termed ————- . It occurs in muscle and liver cells when there is more than enough glucose to meet energy needs (excess glucose).
a) Gluconeogenesis
b) Glycolysis
c) Glycogenesis
d) Glycogenolysis
c) Glycogenesis
- Acidosis due to low bicarbonate
- Low GFR due to high urea and creatinine
- Hyperglycemia due to high plasma glucose
- Ketosis due to high acetoacetate and beta-hydroxybutyrate
- Hyperkalemia due to high potassium
are all symptoms of ____________
diabetic ketoacidosis and renal disease
___________ syndrome is characterised by hyperaldosteronism
Conn’s syndrome is characterised by hyperaldosteronism
_______ helps the cells to get their need of _______. In case of a lack of _______, _______ is not entering the cells (cells think it is a fasting state) and thus cells have to make their own glucose.
(via glycogenolysis, lipolysis, and gluconeogenesis).
insulin helps the cells to get their need of glucose. In case of a lack of insulin, glucose is not entering the cells (cells think it is a fasting state) and thus cells have to make their own glucose.
(via glycogenolysis, lipolysis, and gluconeogenesis).
Two types of cells are exceptions to glucose uptake regulation via insulin receptors - _______ and _______ cells. However, this is only due to the fact that these cells are readily permeable to glucose, even in the absence of _______.
Two types of cells are exceptions to glucose uptake regulation via insulin receptors - brain and liver cells. However, this is only due to the fact that these cells are readily permeable to glucose, even in the absence of insulin.
What is the alternative recommended test by the International Expert Committee if HbA1C is not possible?
FPG or 2HPG
the feeling of thirst is termed
polydipsia
The followings are the triad of diabetic ketoacidosis EXCEPT:
a) Acidemia
b) Hyperglycaemia
c) Hypoglycemia
d) Ketosis
c) Hypoglycemia
A blood glucose test is used to measure the glucose level for the _____ it is monitored only.
A blood glucose test is used to measure the glucose level for the day it is monitored only.
The normal range for a BMI is _______
a) 15-20
b) 20-25
c) 25-30
d) Over 30
The normal range for a BMI is ———-
b) 20-25
which diabetes type can be prevented/reduced?
type 2 diabetes
the common clinical biochemistry diagnostic test to assess any overt decline in renal function is…
Urea/Creatinine (GFR), electrolytes
(UCE/UEC)
——————– is the breakdown of glycogen to form glucose for use as energy (during a shortage of glucose).
a) Gluconeogenesis
b) Glycolysis
c) Glycogenesis
d) Glycogenolysis
d) Glycogenolysis
___________ is defined as women who had diabetes during pregnancy.
gestational diabetes
In sodium/potassium ATPase pump, __________ leave the cell whereas, __________ enter the cell.
In sodium/potassium ATPase pump, 3 sodium Ions leave the cell whereas, 2 potassium Ions enter the cell.
Type __ diabetes has a stronger genetic basis than type __. Yet it also depends more on environmental factors.
Type 2 diabetes has a stronger genetic basis than type 1. Yet it also depends more on environmental factors.
HbA1c was used as an index of glycemic control. Nowadays, it is also used to diagnose ________.
HbA1c was used as an index of glycemic control. Nowadays, it is also used to diagnose diabetes.
In order to decrease pseudohyperkalemia, it is recommended to store the blood at ____ degrees rather than at ____ degrees.
In order to decrease pseudohyperkalemia, it is recommended to store the blood at 37 degrees rather than at 4 degrees.
You should not find glucose in urine in a healthy person because it should be completely reabsorbed by the _______.
You should not find glucose in urine in a healthy person because it should be completely reabsorbed by the kidneys.
Cortisol stimulates gluconeogenesis, whereas __________ stimulates gluconeogenesis, glycogenolysis and lipolysis
Cortisol stimulates gluconeogenesis, whereas adrenaline stimulates gluconeogenesis glycogenolysis and lipolysis
Type __ diabetes usually has an onset age of less than 40, whereas type __ usually has an onset age of more than 40.
Type 1 diabetes usually has an onset age of less than 40, whereas type 2 usually has an onset age of more than 40.
——————– is the synthesis of glucose from non-carbohydrate precursors, such as pyruvate, amino acids and glycerol. It takes place largely in liver (e.g. Krebs cycle) and serves to maintain blood glucose under conditions of starvation or intense exercise.
a) Gluconeogenesis
b) Glycolysis
c) Glycogenesis
d) Glycogenolysis
a) Gluconeogenesis
The increase in fatty acids that result from a lack of insulin to inhibit hormone sensitive lipase, leads to a massive synthesis of ketone bodies in the _______.
These then exceed the buffer capacity of the blood, leading to ___________.
Excess acid is a potent poison for the ______ causing coma and death.
The increase in fatty acids that result from a lack of insulin to inhibit hormone sensitive lipase, leads to a massive synthesis of ketone bodies in the liver.
These then exceed the buffer capacity of the blood, leading to ketoacidosis.
Excess acid is a potent poison for the brain, causing coma and death.
The feeling of hunger is termed
Polyphagia
Most of the patients with _______ diabetes have tissue resistance to insulin.
Most of the patients with type 2 diabetes have tissue resistance to insulin.
name the 4 tests used for diabetes diagnosis and management.
- Plasma / blood glucose
- HbA1C
- Plasma lipids
- Renal function tests
What are the two types organs that don’t need the presence of insulin to uptake glucose?
Brain and liver
the 4 clinical tests to monitor diabetes include?
- HbA1c
- lipids
- urinary albumin
- urea, creatinine, electrolytes
The following are examples of acute complications that require immediate medical attention, EXCEPT:
a) Hyperglycaemia
b) Hypoglycaemia
c) Diabetic ketoacidosis
d) Hyperosmolar coma
a) Hyperglycaemia
(chronic hyperglycaemia requires immediate attention, not acute hyperglycaemia)
Pseudohyperkalemia could result due to collecting blood into a phlebotomy tube containing?
K2EDTA
Insulin helps the cells to get their need of _______. In case of _______ ________, the receptors in the cells do not respond fully to the insulin and less _______ is entering the cells.
Insulin helps the cells to get their need of glucose. In case of insulin resistance, the receptors in the cells do not respond fully to the insulin and less glucose is entering the cells.
________ is the earliest sign of diabetic renal disease.
a) Cholesterol
b) Increase in BUN
c) Increase in triglycerides
d) Low GFR
e) Microalbuminuria
e) Microalbuminuria
Diabetic ketoacidosis results from a shortage of insulin, in response the body switches to burning ___________ and producing ____________
Diabetic ketoacidosis results from a shortage of insulin, in response the body switches to burning fatty acids and producing ketone bodies
Polydipsia means —-
a) Hunger
b) Thirst
c) Frequent urination
d) Weight loss
b) Thirst
In type __ diabetes: patients have insulin resistance + dysfunctional b cells
In type 2 diabetes: patients have insulin resistance + dysfunctional b cells
Type 2 diabetes is usually a problem amongst __________ in developed countries and __________ in developing countries as it is linked to obesity, high calorie intake and sedentary lifestyle.
a) Healthy people
b) Lower socioeconomic classes
c) Higher socioeconomic classes
d) sporty people
Type 2 diabetes is usually a problem amongst Lower socioeconomic classes in developed countries and Higher socioeconomic classes in developing countries as it is linked to obesity, high calorie intake and sedentary lifestyle.
the common clinical biochemistry diagnostic test to assess glycaemic control is _________
the common clinical biochemistry diagnostic test to assess glycaemic control is HbA1C
HbA1c was used to monitor and gives an average of blood glucose level for a period of __________
a) 1-3 weeks
b) 1-3 months
c) More than 4 months
d) More than 6 months
b) 1-3 months
Obesity, family history, gestational diabetes, high blood pressure and high cholesterol are all risks for __________
Obesity, family history, gestational diabetes, high blood pressure and high cholesterol are all risks for Type 2 diabetes
What is the renal threshold for blood glucose level below which all glucose filtered at the glomerulus are reabsorbed?
a) 7 mmol/L
b) 9 mmol/L
c) 11 mmol/L
d) 13 mmol/L
c) 11 mmol/L
__________ is defined as women who had diabetes during pregnancy.
a) Gestational diabetes
b) Type 1 diabetes
c) Type 2 diabetes
d) Type 1 & 2 diabetes
a) Gestational diabetes
Most of the patients with _______ diabetes have a deficiency of insulin.
Most of the patients with type 1 diabetes have a deficiency of insulin.
In pancreatic beta cells, The ________ channel has to open as a response of the blockage/inhibition of the __________ channels and that leads to the release of insulin from its granule.
In pancreatic beta cells, The calcium channel has to open as a response of the blockage of the potassium channel and that leads to the release of insulin from its granule.
Diabetes Mellitus is a disease in which the body doesn’t produce or properly use insulin, leading to ___________
Diabetes Mellitus is a disease in which the body doesn’t produce or properly use insulin, leading to hyperglycaemia
A negative urine dipstick test (does/does not) exclude a Diabetes mellitus diagnosis
A negative urine dipstick test does not exclude a Diabetes mellitus diagnosis
___________ & ___________ hormones increase renal sodium reabsorption (hypernatremia) and decrease potassium renal reabsorption (hypokalemia)
Aldosterone & cortisol hormones increase renal sodium reabsorption (hypernatremia) and decrease potassium renal reabsorption (hypokalemia)
Insulin is a hormone that regulates blood glucose level by signalling the _____ , _______ and _____ cells to take in glucose from the blood to be used for energy.
Insulin is a hormone that regulates blood glucose level by signalling the liver, muscle and fat cells to take in glucose from the blood to be used for energy.
Polyphagia means —-
a) Hunger
b) Thirst
c) Frequent urination
d) Weight loss
a) Hunger
Type 2 diabetes is usually linked to the following EXCEPT
a) active lifestyle
b) high calorie intake
c) obesity
d) sedentary lifestyle
a) active lifestyle
The body’s response to blood sugar requires the coordination of an array of mechanisms. any damage to the ______ cells, which produce _________, will lead to increased levels of blood glucose.
The body’s response to blood sugar requires the coordination of an array of mechanisms. any damage to the beta cells, which produce insulin, will lead to increased levels of blood glucose.
Polyuria means —-
a) Hunger
b) Thirst
c) Frequent urination
d) Weight loss
c) Frequent urination
intake of _______ will allow a recovery from diabetic ketoacidosis
intake of insulin will allow a recovery from diabetic ketoacidosis
Glucagon generally elevates the concentration of glucose in the blood by promoting gluconeogenesis and __________.
a) Glycogenesis
b) Glycogenolysis
c) Glycolysis
b) Glycogenolysis
If the body has sufficient energy, insulin signals the (3 locations) tissues to take up glucose and store it as __________
If the body has sufficient energy, insulin signals the liver, muscle & adipose tissues to take up glucose and store it as glycogen
Diabetic ketoacidosis is usually in type __, whereas hyperosmolar non-ketotic coma is usually in type __.
Diabetic ketoacidosis is usually in type 1, whereas hyperosmolar non-ketotic coma is usually in type 2.
name the characteristics associated the type of diabetes:
- Middle aged, elderly
- Usually overweight/obese
- Family history usual
- Symptoms may be present for months/years
- Do not present with diabetic coma
- Insulin not necessarily required
- Previous diabetes in pregnancy
T2D
What are the two organs/cells that don’t need the presence of insulin to uptake glucose?
Brain & liver cells
The glycolytic phosphorylation of glucose causes a rise in the ________. This rise inactivates the ________ channel that depolarizes the membrane, causing the calcium channel to open up allowing calcium ions to flow inward.
The glycolytic phosphorylation of glucose causes a rise in the ATP/ADP ratio. This rise inactivates the Potassium channel that depolarizes the membrane, causing the calcium channel to open up allowing calcium ions to flow inward.
In type __ diabetes, Insulin levels may be normal, elevated or depressed
In type 2 diabetes, Insulin levels may be normal, elevated or depressed
Lack of insulin and increase of other hormones such as _________ can cause hyperglycemia:
a) T3 & T4
b) Cortisol and Adrenaline
c) Adrenaline
d) Cortisol
e) Oestrogen and Progesterone
b) Cortisol and Adrenaline
Common clinical biochemistry tests in diabetic diagnosis/management are all the following EXCEPT _________
a) HbA1c
b) Liver tests
c) Plasma/blood glucose
d) Plasma lipids
e) Renal function tests
b) Liver tests
HbA1c is more reliable than normal blood glucose test because ________
a) It gives an average of blood glucose for up to 1 week
b) It gives an average of blood glucose for up to 3 weeks
c) It gives an average of blood glucose for up to 3 months
d) It is inexpensive
c) It gives an average of blood glucose for up to 3 months
type __ diabetes is insulin dependent, whereas type __ diabetes is not insulin dependent.
Type 1 diabetes is insulin dependent, whereas type 2 diabetes is not insulin dependent.
Insulin secretion in beta cells is triggered by rising blood ______ levels. Starting with the uptake of glucose by the _______ transporter in the liver.
Insulin secretion in beta cells is triggered by rising blood glucose levels. Starting with the uptake of glucose by the GLUT 2 transporter in the liver.
——————– is the breakdown of glucose. The initial metabolic pathway of cellular respiration in which a series of reactions happening in the cytosol results in the conversion of a monosaccharide, often glucose, into pyruvic acid, and the concomitant production of a relatively small amount of high-energy molecules, such as ATP (Krebs cycle).
a) Gluconeogenesis
b) Glycolysis
c) Glycogenesis
d) Glycogenolysis
b) Glycolysis
Type 1 diabetes is due to a lack of ______
Type 1 diabetes is due to a lack of insulin
A rise in levels of ________ in the cell leads to the exocytotic release of insulin from the insulin storage granules.
A rise in levels of calcium in the cell leads to the exocytotic release of insulin from the insulin storage granules.
In general we can say that insulin favours ________ reactions; more simply, insulin favours _______ energy and production of proteins and lipids.
In general we can say that insulin favours anabolic reactions; more simply, insulin favours storing energy and production of proteins and lipids.
Lack of insulin leads to a marked increase in the rate of lipolysis in _________ due to a lack of inhibition of _____________ by insulin.
Lack of insulin leads to a marked increase in the rate of lipolysis in adipose tissue due to a lack of inhibition of hormone sensitive lipase by insulin.
_________ stimulates gluconeogenesis, whereas __________ stimulates gluconeogenesis and glycogenolysis.
a) Adrenaline
b) Cortisol
Cortisol stimulates gluconeogenesis, whereas Adrenalin stimulates gluconeogenesis and glycogenolysis.
The body’s response to blood sugar requires the coordination of an array of mechanisms. Failure of any one component involved in ______ regulation, secretion, uptake or breakdown can lead to the build-up of _______ in the blood.
The body’s response to blood sugar requires the coordination of an array of mechanisms. Failure of any one component involved in insulin regulation, secretion, uptake or breakdown can lead to the build-up of glucose in the blood.
Hyperosmolar non-ketoic coma is high blood glucose as in ketoacidosis, but without increased _______ and _______.
Hyperosmolar non-ketoic coma is high blood glucose as in ketoacidosis, but without increased ketones and acidosis.
Type 2 diabetes is due to ________ _________
Type 2 diabetes is due to insulin resistance.
Diabetic ketoacidosis results from a shortage of insulin; in response the body switches to burning _________ and producing acidic ________.
Diabetic ketoacidosis results from a shortage of insulin; in response the body switches to burning fatty acids and producing acidic ketone bodies.
Failure to take food after insulin can cause similar effect to an overdose of insulin, which can cause ___________
Failure to take food after insulin can cause similar effect to an overdose of insulin, which can cause hypoglycaemia.
- Storing energy as glycogen
- Production of proteins
- Production of lipids
are all stimulated by _______
insulin
Above a BMI of _____ the risk to type 2 diabetes increases.
a) 15-20
b) 20-25
c) 25-30
d) Over 30
c) 25-30
the common clinical biochemistry diagnostic test to assess indications of nephropathy (kidney disease) and other complications is…
Urinary albumin (microalbuminuria). Initially to detect small amounts of albumin in the urine
________ is a polypeptide hormone that travels around the bloodstream. Binding of insulin to the _______ leads to increased _______ uptake by the cell.
insulin is a polypeptide hormone that travels around the bloodstream. Binding of insulin to the receptor leads to increased glucose uptake by the cell.
Normal blood glucose levels are between:
a) 1.0–5.8 mmol/L
b) 2.0–7.8 mmol/L
c) 4.0–7.8 mmol/L
d) 5.0–8.8 mmol/L
e) 9.0 –11 mmol/L
c) 4.0–7.8 mmol/L
Results ≥ ____ mmol/L on random blood glucose samples require further investigation.
Results ≥ 7.8 mmol/L on random blood glucose samples require further investigation.
The healthy person has plasma glucose level at ______ mmol/L in fasting state.
a) 2 – 3
b) 3.5 – 5.5
c) 5.6 – 6.9
d) > 7
b) 3.5 – 5.5
Can glucosuria be used to diagnose diabetes?
NO
What is the alternative recommended test by the International Expert Committee if HbA1C is not possible?
a) Cholesterol
b) FPG or 2HPG
c) Liver functions
d) Plasma lipids
e) Renal functions
b) FPG or 2HPG
(fasting plasma glucose or 2 hour plasma glucose)
name the characteristics associated the type of diabetes:
- Young age
- Normal BMI, not obese
- No immediate family history
- Short duration of symptoms (weeks)
- Can present with diabetic coma (diabetic ketoacidosis)
- Insulin required
T1D
Obese people are in risk to type __ diabetes.
Obese people are in risk to type 2 diabetes.
the common clinical biochemistry diagnostic test to assess risk of macrovascular disease (coronary heart disease & stroke) is…
plasma lipids including total cholesterol, triglycerides, and LDL & HDL cholesterol,
Insulin upregulates the amount of Na/K pumps at the cell membrane, this causes a downregulation in the amount of __________ channels at the cell membrane
this inhibtion of _________ channels prevent excess _________ secretion
Insulin upregulates the amount of Na/K pumps at the cell membrane, this causes a downregulation in the amount of calcium channels at the cell membrane
this inhibition of calcium channels prevent excess insulin secretion
