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Endocrine/Diabetes
Pathophisiology Test 2 Note cards
| Question | Answer |
|---|---|
| What is the prevalence of diabetes? | 20 million (type 1; type 2 90-95%) |
| What type of abnormalities are associated with Type 1 diabetes? | Absolute insulin deficiency. |
| What is the average decrease in lifespan b/c of DM? | 15 year decrease |
| What is the difference between Type 1A and 1B? | Type 1A is autoimmune and 1B's cause is unknown. |
| What was Type 1 diabetes called in the past? | Juvenile onset diabetes. |
| What was Type 2 diabetes known as in the past? | Adult onset diabetes. |
| What are the characteristics of Type 2 diabetes? | Multifactorial, Decrease or abnormal beta cell fxn, INSULIN RESISTANCE, abnormal receptors or post receptor signals. |
| What does a decrease or abnormal beta cell fxn lead to? | Decrease insulin and amylin. |
| What is amylin? | It fxns to control sugar levels in the blood from the pancreas. |
| What percentage of individuals have insulin resistance in Type 2 diabetes? | 90-95% |
| What are the fasting glucose and 2 hr postprandial levels in Pre-Diabetes? | Fasting Glucose 100-125 2 hour postprandial 140-199 |
| What is Gestational Diabetes Mellitus? | Glucose intolerance related to the demands of pregnancy. |
| What are the characteristics of Metabolic Syndrome? | Obesity, dyslipidemia, insulin resistance, HTN, impaired glucose, Pro-inflammatory states. |
| Which type of diabetes has risks such as autoimmune and has an HLA genetic defect? | Type1A |
| Which type of diabetes has Insulin Auto Antibodies (IAA)? | Type 1A |
| Which type of diabetes has a strong familial lin that is not genetic and has no HLA? | Type 2 |
| Which type of diabetes has an environmental trigger that stimulates production Islet Cells Autoantibodies (ICA) that destroy pancreatic beta cells? | Type 1A |
| Which type of diabetes has truncal obesity as the #1 risk factor with a sedentary BMI > 25? | Type 2 |
| Which type of diabetes has Metabolic Syndrome as a risk? | Type 2 |
| Which type of diabetes has Polycystic Ovary Syndrome as a risk? | Type 2 |
| If you have a history of IFG or GDM what type of diabetes are you at risk for? | Type 2 |
| If you have nonalcoholi fatty liver disease, what type of diabetes are you at risk for? | Type 2 |
| If you have excess hormones such as (GH,cortisol, glucagon, epinephrine) what type of diabetes are you at risk for and why? | Type 2 because they all antagonize insulin. |
| If you have HTN or dyslipedemia, what type of diabetes are you at risk for? | Type 2 |
| What is a desired HgbA1c? | < 6% or 7-8% in the elderly |
| What does a high A1C indicate? | An increase in Cardio Vascular Disease (CVD). |
| At what point does Microvascular disease start? | At Hgb A1C 5.7-5.9 |
| Describe a normal urine sample. | No glucose, no ketones, no protein |
| What is microalbuminuria? | When the kidney leaks small amounts of albumin in the urine b/c of the abnormally high permeability for albumin in the renal glomerulus. |
| What does microalbuminuria indicate? | A risk of kidney involvement because of Diabetes Mellitus. |
| How much kidney fxn is lost at Stage 3 CKD? | 50% |
| What is the interpritation of normal creatinine in the urine? | There is no kidney damage. |
| In which type of diabetes is there altered pancreatic beta cells which equal and absence of fxn insulin? | Type 1 |
| In which type of diabetes is ketoacidosis less common? | Type 2 |
| In which type of diabetes are their excess skin tags and acanghosis nigricans? | Type 2 |
| In which type of diabetes is there insulin resistance? | Type 2 |
| In which type of diabetes is ketoacidosis spontaneous? | Type 2 |
| In which type of diabetes is there absolute insulin deficiency? | Type 1 |
| In which type of diabetes is there low or undetectable plasma C-peptide? | Type 1 |
| Which type of diabetes has receptor/post receptor defects? | Type 2 |
| This type of diabetes has hyperinulinermia due to chronic high BS and insulin resistance in earlier stages. | Type 2 |
| What does a decrease in amylin affect the body? | Increases plasma glucagon. |
| What do alpha cells release? | Glucagon |
| What is C-peptide? | A precursor to insulin. |
| How does a decrease in insulin affect the body? | It increases ketones causing ketoacidosis in patients. |
| How does GLP-1 fxn? | Increases insulin, beta cells, satiety and Decreases glucagon, gastric emptying. |
| Intra-abdominal obesity is the greatest risk factor for what type of diabetes? | Type 2 |
| How does obesity affect insulin and beta cells? | Obesity has inflammatory cytokines (IL-1, IL-6, TNFa) that promote insulin resistance and beta cell death. |
| Polyuria, polydipsia, and polyphagia are seen in what type of diabetes? | Mainly Type 1 but can be seen in Type 2. |
| The 3 P's can be seen in Type 2 diabetes if what occurs? | If the BS is greater than 180 mg/dl. |
| What type of diabetes has pneumoturia and ketonuria? | Type 1 |
| What type of diabetes has pruritis? | Type 2 |
| In Type 2, what does an absence of S/S mean? | That the glucose level is controlled but pathogenesis may still be occurring. |
| Why does osmotic diuresis (polyuria) occur? | B/c of increased blood sugar. |
| What type of diabetes has wt. loss, fatigue, and weakness and why? | Type 1 b/c of the decrease in insulin causing a decrease in the use of nutrients causing hunger. |
| Which type of diabetes can polyphagia (excessive hunger) be seen? | Type 1 |
| What type of diabetes is DKA (diabetic ketoacidosis) seen in ? | More common in Type 1 b/c Type 2 has some insulin so less likely to develop ketones. |
| What type of diabetes is Hyperosmolar Hyperglycemic Non Ketoic Coma (HHNK)seen in? | Only in Type 2 due to presence of some insulin. |
| Name the ACUTE DM complications. | Infections, hypo/hyperglycemia, DKA, HHNK, Somogyi/Dawn Phenomenon. |
| What does hyperosmolarity indicate? | An increase in insulin. |
| What are the s/s of HYPOGLYCEMIA? | BS <60, decreased LOC, sweating, tremors, nervousness, increase pulse palpitations, increase BP, tachypnea. |
| What percentage of beta cells are destroyed before a consistent high BS? | 80-90% |
| What are the S/S of hyperglycemia? | 3 P's, blurred vision, weakness, fatigue, nausea/vomiting, HA, abdominal cramping. |
| What range of BS is considered Hyperglycemia? | >180 but < 500 mg/dl |
| What are the three Hyperglycemia Cell effects? | Glycosylation, Polyol pathway, and increase Protein Kinase C |
| What does glycosylation do? | Binds glucose to collagen/proteins of BV/tissues which causes thickening of basement membranes, and increases cytokines, lipid oxidation and O2 free radicals all causing Tissue Injury. |
| How does an increase in Protein Kinase C affect the body? | In increases insulin resistance, cytokines, and permeability. |
| What parts of the body does the Polyol pathway affect? | Kidneys, lens, nerves, and RBC's. |
| How does the Polyol pathway affect the body? | Unused glucose is converted to sorbitol/fructose in the cells causing an increase in H2O thereby causing cell injury. |
| What are DM Chronic complication? | Diabetic neuropathy, microvasular, and macrovascular complications. |
| Name some diabetic neuropathyies. | Motor= foot drop, wrist drop. Sensory= peripheral/CNS axonal degeneration. Autonomic= decreased SNS response. |
| Name some Microvascular complications. | Dermopathy (harmless brown spots on shins), retinopahty, nephropathy. |
Created by:
jesusrvillarreal
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