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Endocrinology > Pathology of DM > Flashcards

Pathology of DM Flashcards

1
Q

What are the 2 types of DM?

A

Type I and Type II

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2
Q

What is the arrangement of tissue in the pancreas?

A

Acinus

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3
Q

What are present in pancreas histology?

A

Islet of langerhans

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4
Q

What do islets of langerhan make up?

A

Endocrine pancreas

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5
Q

What do B cells secrete?

A

Insulin

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6
Q

What type of cell are most cells in islet of Langerhans?

A

B cells

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7
Q

Where do B cells secrete insulin?

A

Into the capillaries

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8
Q

What stimulates the release of insulin?

A

Intake of food
Converted to glucose
Stimulates insulin production

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9
Q

Where does insulin bind?

A

To its receptors

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10
Q

What does insulin allow?

A

Glucose to be taken up by the cells

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11
Q

What does insulin decrease?

A

Serum glucose

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12
Q

What causes Type I DM?

A

Not entirely known

Autoimmune response by failure of T cells to recognise self from non slef

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13
Q

What can sometimes be seen years later on histology in type I patients?

A

Scarred islets

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14
Q

What is the viral theory behind the aetiology of type I DM?

A

Though that the surface of B cells mimics that of a virus antigen causing an immune attack

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15
Q

What causes type II diabetes?

A

Combination of reduced tissue sensitivity to insulin

Inability to secrete very high levels of insulin

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16
Q

Which type of weight gain is bad for type II diabetes?

A

Expanded upper body visceral fat mass

17
Q

Are pear shaped woman at risk of type II?

A

No

18
Q

What causes gain in body fat? (simple terms)

A

increased energy intake

Decreased energy output

19
Q

What is the response of the pancreas to a decreased insulin receptor sensitivity?

A

To secrete more insulin

20
Q

Why does the pancreas need to secrete more insulin in type 2?

A

Because there is a decreased removal of glucose from the blood to the tissues

21
Q

What does central adiposity lead to?

A

Hyperinsulinaemia

22
Q

When will diabetes not occur with decreased insulin sensitivity?

A

When insulin production can increase at the same rate

23
Q

What controls increased and increased insulin production by B cells?

A

Genes

24
Q

What happens in type II diabetes?

A

There is eventually not enough insulin production to counteract the decreased receptor sensitivity

25
Q

What is the commonest cause of death in type 2?

A

MI

26
Q

Is type II reversible?

A

Yes with weight loss

27
Q

What are the 2 main groups of complication from DM?

A

Microvascular

Macrovascular

28
Q

What is DM a major risk factor for?

A

Atherosclerosis

  • CHD
  • MI
  • Stroke
29
Q

What is one mechanism by which DM accelerates atherosclerosis?

A 
Glc attaches to LDL 
Prevents I attaching to its receptor
Prevents excretion by the liver
Stays in the blood 
Hyperlipidaemia 
Leading to atherosclerosis
30
Q

What is between the basal lamina and endothelial cells?

A

Potential space

31
Q

What happens in microvessels in DM?

A

Molecules flux into subendothelial space but then find it hard to flux back into the blood
Build up of trapped molecules under endothelial cells

32
Q

What happens to the BL in DM?

A

Thickens

33
Q

Which tissues are particularly damaged with small vessel disease?

A

Kidneys
Peripheral tissues
Eyes

34
Q

What is the relative risk of amputation with DM?

A

40 x

35
Q

What is the increased risk of renal disease in DM?

A

25 x

36
Q

What is the increased risk of blindness?

A

20x

37
Q

How do molecules get trapped under epithelium in DM?

A

Glycosylated collagen trapping albumin
or
Glycosylated BL proteins creating rigid cross linked proteins that can not be removed

38
Q

When do complications most likely occur in DM?

A

When there is prolonged poor control

Endocrinology (19 decks)

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