Which cells of the pancreas are lightly staining?
Hormone producing islets of langerhans
What do pancreatic beta cells produce? (most important for exam)
insulin & islet cell amyloid polypeptide (amylin)
What do alpha cells produce?
glucagon
What do delta cels produce?
somatostatin
What do D1 cells produce?
VIP
What do PP cells produce?
pancreatic polypeptide
What do enterochromaffin cells produce?
serotonin
Which GLUT transporter is in adipose and striated muscle?
GLUT 4
T/F - GLUT transporters require insulin to function
T
Lab criteria for diagnosing DM
fasting blood glucose >= 126
non-fasting >= 200 w/ diabetes symptoms
+ OGTT resulting in blood glucose >= 200, 2-3 hrs after ingestion of glucose bolus
Hgb A1C > 6.5%
MC form of DM
Type 2
Type 1 DM is associated with which Abs?
Islet cell Ab, anti-insulin Ab
Most islet cell Ab directed against glutamic acid decarboxylase (GAD) in the beta cells
Islet cell Abs are also found in which other DM aside from type 1?
DM type 1.5 or LADA
Lymphocytic infiltration of islets seen in which DM
Type 1/1.5
Decreased response of peripheral tissues to insulin and then beta cell dysfunction manifested as inadequate insulin secretion
DM type 2
What is likely the largest contributor to the pathogenesis of insulin resistance?
Loss of insulin sensitivity in hepatocytes
MC sxs of DM type 1
polyuria, polydipsia, polyphagia, with lassitude, nausea and blurred vision
What is the term given to infiltration of leukocytes early in the course of DM1 with subsequent islet atrophy and fibrosis?
Insulitis
Islet of langerhans demonstrates pink hyalinization (deposition of amyloid), with almost complete loss of cell detail - which DM?
type 2 - still maintains islet cell function
This type of retinopathy is characterized by dilated capillaries which leak RBC’s and plasma into the substance of the retina, forming cotton wool spots
Non-proliferative diabetic retinopathy
MC cause of visual loss due to diabetic retinopathy
Macular edema
You see diffuse increase in mesangial matrix and acellular PAS-positive nodules in the kidneys
nodular glomerulosclerosis of Diabetic nephropathy
Earliest detectable visible change in diabetic nephropathy
capillary thickening
This pancreatic tumor is separated from the pancreas by a thin collagenous capsule. The neoplastic cells are “monotonous” in appearance, demonstrating minimal pleomorphism or mitotic activity. There is amyloid deposition.
Pancreatic islet cell adenoma
A pancreatic tumor derived from beta cells, whose feedback is not properly regulated by glucose/glucagon
Insulinoma - they present with severe hypoglycemia
5% of insulinomas are associated with what other glands and MEN syndrome?
parathyroid and pituitary - MEN1
An increased cellular uptake of an immunohistochemical stain for insulin is consistent with dx of
insulinoma
A tumor of pancreas or duodenum that secretes gastrin. What does it lead to?
gastrinoma - ulcerations of stomach, duodenum, jejunum, esoph. Also incr HCL and hyperperistalsis, lipase inhibition - get diarrhea
Malignant gastrinomas MC spread where?
Liver and lymph nodes located nearby
Gastrinomas MC location
Duodenum. Less commonly in the pancreas.
What is frequently the source of excess gastrin in Zollinger-Ellison syndrome?
Gastrinoma
25% of Zollinger-Ellison syndrome have multiple tumor types at different sites as a consequence of which MEN?
MEN1 - usually pituitary and parathyroid
