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Endocrinology, Nephrology, Urology, And Breast Surgery > Diabetes Aetiology Diagnosis And Presentation > Flashcards

Diabetes Aetiology Diagnosis And Presentation Flashcards

1
Q

Why type of diabetes usually presents acutely and which present subcutely and non specifically

A

T1 acute
T2 subacute and non specific symptoms

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2
Q

What causes the classical symptoms of diabetes

A

Osmotic effects of hyperglycaemia

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3
Q

Diabetes symptoms

A

Polyuria
Polydipsia
Nocturia
Weight loss
Fatigue
Blurred vision
Pruritis
Recurrent urinary/genitourinary infections

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4
Q

2 types of diabetic emergency

A

Diabetic ketoacidosis DKA
Hyperosmolar hyperglycaemic syndrome HHS

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5
Q

4 types of diagnostic tests for diabetes

A

FPG Fasting plasma glucose
RPG Random plasma glucose
OGTT 75g oral glucose tolerance test
HbA1c

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6
Q

What period of time does HbA1c give information about glucose control over

A

3 month avergae

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7
Q

Normal HbA1c

A

<42mmol/mol

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8
Q

How many tests are required for diabetes diagnosis

A

No symptoms + 2 tests (but only 1 OGTT)
Symptoms + 1 test

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9
Q

Fasting plasma glucose level in patients with diabetes, impaired glucose tolerance, impaired fasting glucose, and healthy

A

7+ Diabetes
<7 IGT
6.1-6.9 IFG
</=6 normal

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10
Q

2 hr plasma glucose level in patients with diabetes, impaired glucose tolerance, impaired fasting glucose, and healthy

A

11.1+ Diabetes
7.8-11.0 IGT
<7.8 IFG
<7.8 normal

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11
Q

Random plasma glucose level in patients with diabetes, impaired glucose tolerance, impaired fasting glucose, and healthy

A

11.1+ diabetes
RPG can’t be used to diagnose IGT or IFG
<7.8 normal

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12
Q

HbA1c in patients with diabetes, impaired glucose tolerance, impaired fasting glucose, and healthy

A

48+ diabetes
42/47 IGT
can’t be used to diagnose IFG
<42 normal

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13
Q

Which antibodies are involved in T1D

A

GAD
ICA

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14
Q

Which HLA variants are linked to T1D and T2D

A

T1 - DR3 DR4
T2 - no HLA link

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15
Q

Which type of diabetes in ketosis prone

A

T1

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16
Q

Which type of diabetes has a stronger genetic link

A

T2

17
Q

Secondary causes of diabetes

A

Pancreatic disease
Endocrine disease
Drug induced
Genetic defects of B-cell function
Genetic defects of insulin action
Infections
Genetic syndromes
Gestational diabetes

18
Q

How can disease of exocrine pancreas cause diabetes

A

Damage B-cells

19
Q

Exocrine pancreas diseases

A

Pancreatitis
Trauma
Pancreatectomy
Neoplasia
Cystic fibrosis
Haemochromatosis/thalassaemia - due to iron overload
Fibrocalculous pancreatopathy

20
Q

Why is fibrocalculous pancreatopathy mainly only seen in developing countries

A

Associated with malnutrition

21
Q

Endocrine diseases that can cause diabetes

A

Acromegaly
Cushing’s
Glucagonoma
Phaeochromocytoma
Hyperthyroidism
Conns

22
Q

Drugs that can induce diabetes

A

Glucocorticoids
Beta blockers
Thiazide diuretics
Tacrolismus
Atypical psychotics

23
Q

What type of diabetes can be caused by tacrolismus

A

NODAT new onset diabetes after transplantation

24
Q

2 infections that can cause diabetes

A

Congenital rubella
CMV

25
Q

2 main features in the pathogenesis of T2D

A

Insulin resistance
B cell failure

26
Q

Glucose toxicity

A

High levels of glucose lead to poorer B-cell function leading to reduced insulin secretion

27
Q

How hoes hyperglycaemia exacerbate diabetes

A

Glucose toxicity

28
Q

How does visceral adiposity contribute to T2D pathogenesis

A

Pro inflammatory cytokines from adipocytes contribute to insulin resistance

29
Q

How does B-cell and Acell population change in T2D

A

B-cell mass preserved
A cell incr

30
Q

Why is excess glucagon released relative to insulin in T2D

A

A cell population increase

31
Q

Which protein is deposited in the pancreatic islets in late T2D

A

Amyloid peptide

32
Q

Features in metabolic syndrome

A

Central obesity +
2 of - low HDL conc, high triglycerides, high BP, high fasting glucose

33
Q

Which groups are screened for T2D

A

BMI 30+
Strong family hx
GD
South Asian/ Afro Caribbean
Known vascular disease
On steroids/ atypical antipsychotics / transplants
Unexplained foot ulcers / recurrent Candida / skin abcesses

34
Q

Characteristics of LADA

A

Latent autoimmune diabetes in adults
Diagnosed in adulthood
Usually non acute
ICA/GAD +ive
Require insulin

35
Q

Which condition is LADA often misdiagnosed as

A

T2D

36
Q

T1D pathogenic sequence

A

Genetic susceptibility -> environmental insult -> insulinitis -> activation of autoimmunity -> immune attack on B-cells

37
Q

What proportion of B-cells can be destroyed before diabetes symptoms occur

A

90%

Endocrinology, Nephrology, Urology, And Breast Surgery (4 decks)

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