Week 1 - Diabetes Patho

Question 1

What are the 4 counter regulatory hormones?

Answer 1

Cortisol
Epi
glucagon
growth hormone

Question 2

Do the counter regulatory hormones increase or decrease blood sugar?

Answer 2

increase

Question 3

What are the 4 things that the incretin hormone GLP-1 (glucagon like peptide) does to control blood sugar levels?

Answer 3

1. talks to the pancreas to release insulin - drops BS
2. talks to the pancreas to stop glucagon - stops BS rise
3. slows gastric emptying - prevent hyperglycemia

Question 4

What 3 things does insulin do for the cell?

Answer 4

helps it take in
1. glucose
2. K+
3. amino acids

Question 5

glycogenesis in the liver and muscle cells

Answer 5

glucose to glycogen storage
(genesis - making glycogen)

Question 6

glycogenolysis in the liver

Answer 6

glycogen stores broken down to release glucose

Question 7

gluconeogenesis

Answer 7

breakdown of proteins to make glucose

Question 8

what are the 5 aspects of metabolic syndrome?

Answer 8

1. HTN
2. Diabetes
3. Central obesity
4. high LDL
5. low HDL

Question 9

Insulin is decreased when activity is (decreased/increased) and food intake is (decreased/increased)

Answer 9

increased
decreased

Question 10

Insulin is increased when stress is (decreased/increased) and infection is (increased/decreased)

Answer 10

increased
increased

Question 11

What are the macrovascular consequences of DM?

Answer 11

1. Brain
2. Heart
3. extremities

Question 12

Is atherosclerosis microvascular or macrovascular?

Answer 12

macrovascular

Question 13

What does the macrovascular effect of DM do to the brain?

Answer 13

1. stroke (TIA)
2. decrease mental status

Question 14

What does the macrovascular effect of DM do to the Heart?

Answer 14

CAD (arteries) due to HTN and insulin resistance

Question 15

What does the macrovascular effect of DM do to the extremities?

Answer 15

PVD - feet and hands - gangrene- necrosis

Question 16

what are the 3 chronic complications of DM (macrovascular)?

Answer 16

1. Stroke
2. Heart attack (MI)
3. PAD

Question 17

what are the 3 things that occur with DMII?

Answer 17

1. tired beta cells
2. insulin resistance on muscle, fat, liver
3. liver is unreliable (basal & bolus insulin)

Question 18

What are the 3 microvascular complications of DM?

Answer 18

1. Eye problems
2. Kidney issues
3. Neuropathy

Question 19

What eye problems occur with DM?

Answer 19

retinopathy
glaucoma
cataracts

Question 20

what are the 2 kidney problems that occur with DM?

Answer 20

1. HTN (glomerulus filtration issue)
2. over worked kidney trying to constantly deal with too much sugar

Question 21

what are the 2 neuropathy problems that occur with DM?

Answer 21

1. nerve damage = no feeling and worse damage = gangrene and numbness
2. PNS/SNS impaired

Question 22

What are the 4 reasons why infection is bad with DM?

Answer 22

1. inflammatory cells have problems (neutrophils, phagocytes, monocytes)
2. increase in yeast infections (sugar)
3. increase in UTI - (sugar in urine)
4. can’t feel infected areas- gangrene

Question 23

What are the 7 signs of hyperglycemia?

Answer 23

1. glucoseuria
2. polyuria
3. polydipsia
4. polyphagia
5. weight loss
6. blurry vision/ blind
7. dehydration

Question 24

what are the 7 signs of early hypoglycemia and what is the bs number?

Answer 24

1. diaphoresis
2. tremors
3. hunger
4. nervous
5. anxious
6. pallor
7. pallpations
   <4 mmol/L

Question 25

what is the late stage of hypogycemia and what is the progression and what is the bs number?

Answer 25

neuroglycopenic confused/can't speak, seizure, coma, death <2.8 mmol/L

Question 26

What type of DM does DKA affect ONLY

Answer 26

Type 1 19-28 mmol/L

Question 27

What is DKA and why does it happen?

Answer 27

hyperglycemia because the body can't use the glucose due to not enough insulin

Question 28

What physiological process does DKA lead to?

Answer 28

break down of fat for glucose - ketogenesis

Question 29

What does prolonged ketogenesis lead to?

Answer 29

Metabolic acidosis Kussmal respirations

Question 30

Why does dehydration occur in DKA?

Answer 30

because in metabolic acidosis there are too many H+ ions and they kick K+ into the blood stream. Na+ goes into the blood stream to try to get keytones out. loss of K+ and Na+ in urine. Where Na+ goes - so does water

Question 31

What makes acidosis worse?

Answer 31

vomitting because eventually all the bicarb is thrown up and you are left with H+ - which leads to dehydration as in DKA

Question 32

What is hyperosmolar hyperglycemic state (HHS) and which type of diabetes does it occur in?

Answer 32

type II > or equal to 34 mmol/L too much glucose and not enough insulin (but can still deal with it somewhat) causes osmotic diuresis

Question 33

What electrolytes are lost in HHS?

Answer 33

Na+, K+, Phos =dehydration (water follows Na+)

Question 34

will hematocrit be high or low with HHS?

Answer 34

high - b/c of lots of Na+ in blood stream compared to fluid

Question 35

what are late stages of hyperglycemia in a type 1 diabetic?

Answer 35

severe dehydration fruity breath kussmals respirations abdominal pain lethargy - coma

Question 36

why might someone with diabetes develop hypoglycemia?

Answer 36

1. meds effects 2. lack glucose 3. too much insulin

Question 37

What are the 4 *classic* symptoms of hyperglycemia?

Answer 37

1.Polyuria 2. Polydipsia 3. glucoseuria 4. elevated bs

Question 38

what is diabetic foot?

Answer 38

motor neuropathy= foot deformities can't feel toes, lose them, pressure ulcers etc. (microvascular) - lack of circulation to the extremities (macrovascular)