DM Flashcards Preview

Physiology > DM > Flashcards

Flashcards in DM Deck (58):
1

What is type Ia DM?

Immune mediated destruction of islet cells

2

What is type Ib DM?

idiopathic destruction of islet cells

3

What is the endocrinopathy that causes DM?

Somtatostatinoma

4

What are the diseases that can lead to DM?

Pancreatitis, CF, CA

5

What is the hormone that causes GDM?

Progesterone

6

What is the normal fasting plasma glucose levels?

<100 mg/dL

7

What is the normal plasma glucose level 2 hours after a meal?

<140 mg/dL

8

What is the diabetic fasting bg level?

>126 mg/dL

9

What is the diabetic bg level 2 hours after glucose load?

>200 mg /dL

10

What are the cells that are destroyed in DM I?

Beta cell destruction

11

True or false: any drop in beta cells will change bg levels?

False-there are more beta cells that needed to meet demand

12

What are the genes that are associated with DM I?

DQ and DR genes of the MHC class II

13

What are the two haplotypes that are associated with DM I?

DR3 and DR4

14

What are the antibodies that can be detected in DM I?

autoantibodies to islet cells, insulin, others

15

Are the antibodies responsible for the destruction of islet Beta cells?

no, infiltration of activated T lymphocytes in beta cells is.

16

What are the two possible triggers for DM I?

Toxins or viruses

17

What is the effect of breastfeeding on the development of DM I?

Decreases risk

18

What is the effect of living in first world countries on DM I?

Increases risk

19

How could viruses theoretically cause the development of DM I?

Molecular mimicry

20

What happens to gluconeogenesis in DM I?

increases

21

What happens to glycogenolysis in DM I?

Increases

22

What happens to glycolysis in DM I?

Decreases

23

What happens to lipolysis/ketone production in DM I?

Increases

24

What causes blurred vision seen in DM I?

Hyperosmolar state

25

What causes the weight loss seen in DM I?

Depletion of water
Loss of muscle mass

26

What causes the weakness/dizziness seen in DM I?

Postural hypotension
K loss and loss of muscle catabolism

27

What causes the paresthesias seen in DM I?

Temporary peripheral sensory nerve dysfunction

28

What causes LOC with DM I?

Dehydration of tissues
DKA

29

What are the three ways to manage DM I?

Diet
Edu
Insulin

30

Why can insulin not be given PO?

Peptide would be degraded by GI

31

What are the two causes of DM II?

Insulin resistance or secretory defect (or both)

32

What happens to Beta cell mass in DM II?

Increase since there is no uptake of glucose

33

What happens to the insulin receptors in DM II?

Less of them OR decrease affinity to insulin

34

What are the three adipokines?

Leptin
IL-6
TNF-alpha

35

What is the effect of adipokines?

Recruits immune cells

36

Can an increase in insulin and beta cell mass overcome insulin resistance?

Yes

37

What causes the increased beta cell stress in DM II?

Increased ER stress
Adipokines
Ectopic fat deposition in islets

38

What is metabolic syndrome?

Hyperglycemia associated with:

Hyperinsulinemia
Dyslipidemia
HTN

39

Metabolic syndrome can lead to what?

CAD and Stroke

40

What is the effect of insulin on Na retention?

Increases

41

What is the effect of insulin on VLDL secretion?

Increases

42

What is the effect of insulin on vascular smooth muscle cell proliferation? What does this result in?

Increases--results in atherosclerosis

43

What is the significance of metabolic syndrome on management?

Changes therapeutic approach

44

Which DM type has a higher concordance rate between monozygotic twins?

Type II

45

What are the genes that predispose someone to DM II involved in?

Beta cell function

46

Why are infections more common in DM II?

high sugar blood = good for bacteria

47

What are the classic, severe signs/symptoms of DM II?

Polyuria, polydipsia, blurred vision, weakness

48

What are the pharmacologic strategies toward DM II?

1. Increase insulin secretion or action
2. Inhibits gluconeogenesis
3. Inhibit glucose digestion/absorption
4. Suppress glucagon

49

What is the effect of drugs that mimic GLP1 on treating DM II?

Promotes insulin secretion

50

What is the effect of drugs that inhibit DDPP4 on treating DM II?

inhibits GLP1 degradation

51

What is the effect of drugs that sulfonylurease and meglitinde analogs on treating DM II?

Inhibits that ATP sensitive K pump on beta cells which closes the channel and causes a depolarization

52

What is the effect of drugs that thiazolidinediones on treating DM II?

Promote the expression of GLUT1 and GLUT4, and thus increase glucose uptake in peripheral tissues

53

What are the symptoms of hypoglycemia?

Tachycardia
Sweating
Tremors
Nausea
Hunger

54

What are neuroglycopenia symptoms

Irritability
Confusion
HA
Speech difficulty
Blurred vision
LOC

55

What is the treatment for hypoglycemia?

Glucagon/glucose

56

What causes DKA?

insulin deficiency causes lipolysis, causing acidification of the blood

57

When is DKA seen in DM II pts?

Sepsis, trauma, or surgery

58

What are the treatment goals of DKA?

Restore plasma volume
Reduces glucose
Correct acidosis
Replenish electrolytes