Quiz 3 Part 5

Question 1

Which cells of the pancreas are lightly staining?

Answer 1

Hormone producing islets of langerhans

Question 2

What do pancreatic beta cells produce? (most important for exam)

Answer 2

insulin & islet cell amyloid polypeptide (amylin)

Question 3

What do alpha cells produce?

Answer 3

glucagon

Question 4

What do delta cels produce?

Answer 4

somatostatin

Question 5

What do D1 cells produce?

Answer 5

VIP

Question 6

What do PP cells produce?

Answer 6

pancreatic polypeptide

Question 7

What do enterochromaffin cells produce?

Answer 7

serotonin

Question 8

Which GLUT transporter is in adipose and striated muscle?

Answer 8

GLUT 4

Question 9

T/F - GLUT transporters require insulin to function

Answer 9

T

Question 10

Lab criteria for diagnosing DM

Answer 10

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%

Question 11

MC form of DM

Answer 11

Type 2

Question 12

Type 1 DM is associated with which Abs?

Answer 12

Islet cell Ab, anti-insulin Ab

Most islet cell Ab directed against glutamic acid decarboxylase (GAD) in the beta cells

Question 13

Islet cell Abs are also found in which other DM aside from type 1?

Answer 13

DM type 1.5 or LADA

Question 14

Lymphocytic infiltration of islets seen in which DM

Answer 14

Type 1/1.5

Question 15

Decreased response of peripheral tissues to insulin and then beta cell dysfunction manifested as inadequate insulin secretion

Answer 15

DM type 2

Question 16

What is likely the largest contributor to the pathogenesis of insulin resistance?

Answer 16

Loss of insulin sensitivity in hepatocytes

Question 17

MC sxs of DM type 1

Answer 17

polyuria, polydipsia, polyphagia, with lassitude, nausea and blurred vision

Question 18

What is the term given to infiltration of leukocytes early in the course of DM1 with subsequent islet atrophy and fibrosis?

Answer 18

Insulitis

Question 19

Islet of langerhans demonstrates pink hyalinization (deposition of amyloid), with almost complete loss of cell detail - which DM?

Answer 19

type 2 - still maintains islet cell function

Question 20

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

Answer 20

Non-proliferative diabetic retinopathy

Question 21

MC cause of visual loss due to diabetic retinopathy

Answer 21

Macular edema

Question 22

You see diffuse increase in mesangial matrix and acellular PAS-positive nodules in the kidneys

Answer 22

nodular glomerulosclerosis of Diabetic nephropathy

Question 23

Earliest detectable visible change in diabetic nephropathy

Answer 23

capillary thickening

Question 24

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.

Answer 24

Pancreatic islet cell adenoma

Question 25

A pancreatic tumor derived from beta cells, whose feedback is not properly regulated by glucose/glucagon

Answer 25

Insulinoma - they present with severe hypoglycemia

Question 26

5% of insulinomas are associated with what other glands and MEN syndrome?

Answer 26

parathyroid and pituitary - MEN1

Question 27

An increased cellular uptake of an immunohistochemical stain for insulin is consistent with dx of

Answer 27

insulinoma

Question 28

A tumor of pancreas or duodenum that secretes gastrin. What does it lead to?

Answer 28

gastrinoma - ulcerations of stomach, duodenum, jejunum, esoph. Also incr HCL and hyperperistalsis, lipase inhibition - get diarrhea

Question 29

Malignant gastrinomas MC spread where?

Answer 29

Liver and lymph nodes located nearby

Question 30

Gastrinomas MC location

Answer 30

Duodenum. Less commonly in the pancreas.

Question 31

What is frequently the source of excess gastrin in Zollinger-Ellison syndrome?

Answer 31

Gastrinoma

Question 32

25% of Zollinger-Ellison syndrome have multiple tumor types at different sites as a consequence of which MEN?

Answer 32

MEN1 - usually pituitary and parathyroid