Diabetes Mellitus Pathology Flashcards Preview

Jonathan's Metabolism > Diabetes Mellitus Pathology > Flashcards

Flashcards in Diabetes Mellitus Pathology Deck (15):
1

Which cells can respond to insulin?

adipose tissue
striated muscle
liver

2

What are the major changes diabetes mellitus cause?

macrovascular
microvascular
cellular

3

What are the microvascular effects of DM?

kidney diabetic nephropathy
retina diabetic retinopathy
delayed wound healing

4

What kind of cellular changes is microvascular complication usually associated with?

glycosylation of proteins that is initially reversible, but later becomes stable

5

What is papillary necrosis?

coagulative necrosis of deep medullary pyramids

6

What do kidneys of late stage diabetic patients look like?

scarred with nodular appearance due to macro and micro-vascular injuries

7

What is Kimmelstiel Wilson nodules?

Spherical nodules arising in mesangium and eventually becoming balls of collagen

8

Does the wall thickening cause protein leakage?

No, it's more because of the disturbance of charge on the basement membrane

9

How does diabetes cause retinopathy

primarily due to ischaemia related to microvascular injury and reduced perfusion

10

Why is foot care a critical part of managing DM

neuropathy - can't feel injury, and consequently frequent trauma
impaired healing
impaired immune system

11

T/F AGEs are normal molecules in the body

True, but the formation speeds up in hyperglycaemia

12

What is the effect of AGE when binding to RAGE ?

binding to receptor RAGE on inflammatory cells, endothelial cells and vascular smooth muscle

13

What is the effect of AGE cross linking with extracellular matrix proteins

cross link with type I collage to cause vessel injury
cross link to type IV collagen to alter BM permeability
cross link to protein, making them resistant to degradation
AGE matrix can trap LDL to accelerate atheroma

14

What is the effect of inappropriately activating PKC?

pro-angiogenic
increase tendency to small vessel constriction
induce production of BM and matrix
pro-inflammatory cytokine release

15

What kind of liver disease does DM cause?

NASH