pancreas path 2

Question 1

diabetic microangiopathy

Answer 1

• small vessel disease –> hyaline arteriolosclerosis
• THICKENING OF BASEMENT MEMBRANES is one of the MOST CONSISTENT morphologic feature of diabetes
  
  • esp in retinal and renal glomeruli
• DIABETIC CAPPILARIES ARE MORE LEAKY THAN TO PLASMA PROTEINS THAN NORMAL CAPPILLARIES

Question 2

Diabetic microangiopathy comparied to normal

Answer 2

• DIABETIC
  
  • THICK, NARROW and LEAKY SMALL BLOOD VESSELS
    
    • esp in kidnesy and eyes

Question 3

long term complications of DM

Answer 3

• damage to blood vessels in kidneys
  
  • diabetic nephrosclerosis
  • pyelonephritis
  • papillary necrosis
• damage to blood vessels in eyes
  
  • exudative and proliferative retino
• damage to nerves
  
  • symmetric polyneuropathy
• peripheral vascular disease
• coronary artery disease

Question 4

kidney infections

Answer 4

• Gram-negative bacilli –> pylonephritis (renal pelvis)
• Staphylococci –> cortical infections

Question 5

Neuropathy

Answer 5

• Sensory –> motor
• Peripheral neuropathy
  
  • bilateral, symmetric
  • progressive, irreversible
  • paraesthesia, pain, muscle atrophy
• Visceral neuropathy
  
  • cranial nerve - diplopia, bells palsy
  • GIT = constipation, diarrhea
  • CVS = orthostatic hypotension

Question 6

diabetic Macroangiography

Answer 6

• large vessel disease
• ACCELERATED ATHEROSCLEROSIS
  
  • STROKES
  • gangrene of lwoer extremites
  • MI
• Nonenzymatic glycosylation of lipoproteins seems to be the problem
  
  • LDLs “stick” best to glycosylate collaged
  • Advanced glycation end products (AGEs) cause the production of fibrous tissue.
• GoOD GLYCEMIC CONTROl does help accelerated atherosclerosis.

Question 7

diabetic retinopathy

Answer 7

• ISCHEMIA due to microangiopathy and ATHEROSCLEROSIS serves as a stimulus for neovascular proliferation
• constellation of chagnes in the retina
  
  • pal area of edema around the central avascular macula
  • neovascularization
  • hemorrhagic foci