carbohydrate metabolism disorder

Question 1

what are the glucose metabolism

Answer 1

glycolysis

kerb cycle

oxidative phosphorylation

Question 2

what is glycolysis and what does it produce?

Answer 2

Break down glucose and produce pyruvate

Produces 2 ATP and 2NADH

Question 3

what is the primary regulatory hormone in glucoregulation?

Answer 3

insulin

Question 4

action of the insulin

Answer 4

binds to extracellular alpha-subunits

which cause a conformational change

Question 5

role of insulin on glucose

Answer 5

insulin facilitates the translocation of GLUT-4 from vesicles to the cell membrane

Question 6

What does GLUT-4 do?

Answer 6

Forms a pore that allows glucose to diffuse into the cells

Question 7

where is glucose stored?

Answer 7

liver in the form of glycogen

Question 8

does insulin have any relation with rate of glycogen synthesis?

Answer 8

yes

insulin increases the rate of glycogen synthesis by activating glycogen synthase

insulin decrease the rate of glycogen breakdown

Question 9

what other function does insulin have other than glucose synthesis?

Answer 9

increase lipogenesis

promotes protein synthesis

counter-regulatory hormones

Question 10

what does hyperglycaemia mean?

Answer 10

high blood sugar level

Question 11

What is diabetes mellitus

Answer 11

most prevalent cause of hyperglycaemia

lack of / insensitivity to insulin

Question 12

type 1 DM

Answer 12

absolute lack of insulin

cause by autoimmune destruction of pancreatic beta cells

Question 13

what are pathogenesis of type 1 DM?

Answer 13

lymphocytes infiltrate into pancreatic islets and destroy B-cells

Question 14

symptoms of type 1 DM

Answer 14

• thirst
• polyuria / nocturia
• dehydration
• fatigue
• diabetic ketoacidosis

Question 15

what’s so special about diabetic ketoacidosis?

Answer 15

occurs in type 1 DM only

insulin deficiency that can cause:
- gluconeogenesis
- glycogenesis
- decreased peripheral utilization of glucose
increased metabolism of fatty acids and ketones as energy substrates

Question 16

what is shock

Answer 16

insufficient blood circulating into the tissues

Question 17

what are the types of shock

Answer 17

Hypovolemic
Cardiogenic
Obstructive
Distributive

Question 18

what is obstructive shock

Answer 18

anatomical blockage of the great vessels of the heart

which leads to decreased venous return, increased afterload, and decreased cardiac output

Question 19

what is cardiogenetic shock

Answer 19

a life-threatening condition in which your heart suddenly can’t pump enough blood to meet your body’s needs

Question 20

What is hypovolemic shock

Answer 20

an emergency condition in which severe blood or other fluid loss, then makes the heart unable to pump enough blood to the body
cause organs to stop working

Question 21

what is distributive shock

Answer 21

a medical condition in which abnormal distribution of blood flow in the smallest blood vessels results in an inadequate supply of blood to the body’s tissues and organs.

Question 22

how can we manage type 1 DM

Answer 22

exogenous insulin

pancreas transplant

islet cell transplant

artificial pancreas

Question 23

what are the treatment of DKA

Answer 23

• insulin
• fluid replacement
• potassium (ONLY if the patient is hypokalaemic)
• bicarbonate

Question 24

what is hypokalaemia

Answer 24

low potassium level in your blood stream

Question 25

causes of cerebral oedema

Answer 25

inflammation fluid overload coagulopathy

Question 26

what is diabetes mellitus type 2

Answer 26

insulin resistance - decreased biological response to normal insulin levels mechanism unclear - defect in intracellular signalling pathway for insulin receptor to be active

Question 27

what is diabetic nephropathy

Answer 27

progressive kidney disease caused by damage to the capillaries in the kidney glomeruli lead to end stage i.e. renal failure

Question 28

define chronic complications

Answer 28

long-term problems that can developm gradually

Question 29

define acute complications

Answer 29

short-term problem that can happen anytime

Question 30

types of chronic complication of diabetes

Answer 30

``` retinopathy Nephropathy Neuropathy ischaemic heart disease cerebrovascular disease peripheral vascular disease ```

Question 31

where will Diabetic nephropathy first affects?

Answer 31

glomerular basement membrane (GBM)

Question 32

how will DN cause a problem?

Answer 32

Increase glycoprotein in glomeruli | change in permeability and increase in hydrostatic pressure

Question 33

treatment for diabetic nephropathy

Answer 33

improved glycaemic control | treatment with anglotensin converting enzyme inhibitor (ACE)

Question 34

what is diabetic retinopathy

Answer 34

caused by microvascular complication

Question 35

how does diabetic retinopathy affects us

Answer 35

microanuerysms burtst causing occlusion of sight

Question 36

why do complications hppen

Answer 36

hyperglycaemia promotes non-enzymatic attachment of glucose to protein molecules schiff base <== glucose + non-enzymatic v changes physical / biochemical structure v reduces its solubility and result in cataract formation

Question 37

What are the macrovascular disease (give example)

Answer 37

big vessel disease i.e. heart disease cerebrovascular disease

Question 38

prevention of macrovascular disease

Answer 38

``` stop smoking reduce cholesterol level arterial surgery angioplasty stents ```

Question 39

What is hypoglycaemia

Answer 39

where plasma glucose is < 2.2mmol/L

Question 40

symptoms of hypoglycaemia during sleep

Answer 40

crying out or having nightmares sweating enough to make your pj / sheets damp feeling tired, irritable to confused after waking up

Question 41

What causes hypoglycaemia

Answer 41

error of metabolism - galactosaemia - hereditary fructose intolerance - glucogen storage disease

Question 42

what is galactosaemia

Answer 42

galactokinase deficiency metabolic disorder

Question 43

how many types in galactosaemia

Answer 43

3

Question 44

why is hypoglycaemia so significance

Answer 44

lactose is broken down into glucose and galactose toxin level buid up galactose-1-phosphate ==> galactitol

Question 45

causes of hypoglycaemia

Answer 45

liver disease endocrine disease adrenal failure stress