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Endocrinology > T1DM > Flashcards

T1DM Flashcards

1
Q

T1DM is associated with what other autoimmune diseases?

A 
thyroid
coeliac
addison's
pernicious anaemia
vitiligo
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2
Q

1 in 20 people with what have TIDM?

A

coeliac

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3
Q

20% of all T2DM

Slowly-progressive disease onset

Non-obese

No FHx T2DM

Age >35 y at onset

Mild IR

Low c-peptide

HLA gene positive (GAD)

80% GAD+ -> insulin-dependence in 6 years

diagnosis?

A

LADA

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4
Q

what does LADA stand for?

A

latent autoimmune diabetes of adulthood

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5
Q 
Addison’s disease
Hypothyroidism
Hypogonadism
Vitiligo
Coeliac disease

T1DM may be associated with all of the above in what?

A

polyglandular endocrinopathy type 2

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6
Q

type 1 endocrinopaty is autosomal what?

A

autosomal recessive

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7
Q

mild immune deficiency

mucocutaneous candidiasis and additionally alopecia, pernicious anaemia, hypoparathyroidism is seen in what?

A

type 1 endocrinopathy

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8
Q

lymphocytes attacking islets is seen in what?

A

T1DM

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9
Q

amyloid deposition is seen in what?

A

T2DM

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10
Q

name the important islet autoantibodies

A

GAD
IA-2
IA-2beta
ZN-T8

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11
Q

GAD is more associated with T_DM than T_DM

A

GAD is more associated with T1DM than T2DM

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12
Q

what chromosome is important in T1DM?

A

chromosome 6

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13
Q

what antigen is important in T1DM?

A

HLA

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14
Q

insulin deficiency results in:

  • decreased _______ uptake
  • increased _______ catabolism
  • increased _________
A
  • decreased GLUCOSE uptake
  • increased PROTEIN catabolism
  • increased LIPOLYSIS
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15
Q

state the classical symptoms fo T1DM

A

polyuria
polydipsia
weight loss
general malaise

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16
Q

vomiting
abdominal pain
altered consciousness
acidotic breathing

diagnosis?

A

DKA

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17
Q 
Acute Onset
Presents with DKA or severe symptoms
Peak incidence pre-school and peri-puberty
Non-obese
Insulin dependent
Family history uncommon

diagnosis?

A

T1DM

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18
Q 
Slow onset – typically present for 6 to 10 years before presentation
Middle-aged /elderly
Obese & Sedentary
Non-insulin dependent
Family history common

diagnosis?

A

T2DM

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19
Q

diagnosis of T1DM is based on history and presentation (eg DKA) but ___________ and _-_______ may help

A

diagnosis of T1DM is based on history and presentation (eg DKA) but ANTIBODIES and C-PEPTIDE may help

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20
Q

name the diet of dose adjustment for normal eating

A

DAFNE

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21
Q

the benefits of good glucose control in diabetics are reduced ____________ and _____________ complications

A

the benefits of good glucose control in diabetics are reduced MICROVASCULAR and MACROVASCULAR complications

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22
Q

HbA1c (mmol/mol):

normal -
prediabetes -
diabetes -

A

normal - <42
prediabetes - 42-47
diabetes - 48 or over

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23
Q

HbA1c (%):

normal -
prediabetes -
diabetes -

A

normal - <6%
prediabetes - 6-6.4%
diabetes - 6.5% or over

24
Q

name the 3 microvascular risks of diabetes

A

retinopathy
nephropathy
neuropathy

25
Q

name 4 things that relate to glucose variability

A

injection
tissue
external factors
carbohydrate delivery

26
Q

insulin secretion in response to a meal is __phasic

A

insulin secretion in response to a meal is BIphasic

27
Q

what is usually seen in the urine of a T1DM patient?

A

ketone bodies

28
Q

c-peptide in a T1DM patient is usually high or low?

A

low

29
Q

children diagnosed under the age of six months are much more likely to have _________ rather than T1DM

A

children diagnosed under the age of six months are much more likely to have MONOGENIC rather than T1DM

30
Q

a diagnosis of what is established by the presence of
elevated levels of pancreatic auto-antibodies in patients
with ‘recently diagnosed’ diabetes who do not initially
require insulin?

A

LADA

31
Q

what does LADA stand for?

A

LAtent onset Diabetes of Adulthood

a.k.a slowly progressive T1DM

32
Q

occurs in young adults 25 to 40

male preponderance

usually non-obese

auto-antibody positive

associated auto-immune conditions

non-insulin requiring at diagnosis

sub-optimal control on oral agents

diagnosis?

A

LADA

33
Q

people with what lung disease is diabetes common in?

A

cystic fibrosis

34
Q

Diabetes Insipidus
Diabetes Mellitus
Optic Atrophy
Deafness

Neurological anomalies

diagnosis?

A

DIDMOAD or Wolfram syndrome

autosomal recessive

35
Q 
Often very obese
Polydactyly
Hypogonadal
Visual impairment
Hearing impairment
Mental retardation
Diabetes

diagnosis?

A

bardet-biedl syndrome

36
Q

short/severe
ketones in urine
antibodies positive

diagnosis?

A

T1DM

37
Q

longer/variable
ketones 0/++
antibodies positive
insulin delayed

diagnosis?

A

LADA

38
Q

variable
ketones 0/+
antibodies negative
inheritance

diagnosis?

A

MODY

39
Q

long/mild
ketones 0
antibodies negative
overweight

diagnosis?

A

T2DM

40
Q

name some diseases associated with diabetes

A 
thyroid
coeliac
pernicious anaemia
Addison's disease
IgA deficiency

rare:

autoimmune polyglandular syndromes (T1 and T2)
AIRE mutations
IPEX syndrome

41
Q 
often asymptomatic
bloating/diarrhoea
malabsorption
anaemia
low albumin and calcium
anti TTG antibodies
IgA deficiency
duodenal biopsy

diagnosis?

A

coeliac disease

42
Q 
Addisons disease
vitiligo
primary hypogonadism
primary hypothyroidism
coeliac disease

the above are all type _ polyglandular endocrinopathies

A 
Addisons disease
vitiligo
primary hypogonadism
primary hypothyroidism
coeliac disease

the above are all type 2 polyglandular endocrinopathies

43
Q

muck-cutaneous candidiasis
primary hypoparathyroidism
pernicious anaemia
alopecia

the above are all type _ polyglandular endocrinopathies

A

muck-cutaneous candidiasis
primary hypoparathyroidism
pernicious anaemia
alopecia

the above are all type 1 polyglandular endocrinopathies

44
Q

1 in __ with thyroid disease have T1DM

A

1 in 20 with thyroid disease have T1DM

45
Q

bardet-biedl syndrome is seen in _______________ parents

A

bardet-biedl syndrome is seen in CONSANGUINEOUS parents

46
Q

what are lumps under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin. It may be unsightly, mildly painful, and may change the timing or completeness of insulin action

A

lipohypertrophy

47
Q

too much insulin can result in what?

A

hypoglycaemia

48
Q

who should receive IV insulin?

A

those with DKA or HHS or acute illness or fasting patients

49
Q

the following are indications for what:

Severe hypoglycemia/ metabolic complications

Incapacitating clinical or emotional problems

A

pancreas transplant

50
Q

replacing only the endocrine component of the pancreas is called what?

A

pancreatic islet transplantation

51
Q

what should you be careful about in DKA treatment for under 18s?

A

fluid resuscitation

52
Q

what is there the risk of in fluid resuscitation in DKA in under 18s?

A

cerebral oedema

53
Q

what are you at risk of if your insulin pump breaks?

A

DKA

54
Q

name the screening test performed in congenital thyroid disease

A

Guthrie test

55
Q

hyperpigmentation of the scrotum and virtualised newborns are due to what condition?

A

congenital adrenal hyperplasia

Endocrinology (31 decks)

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