XX - The Endocrine System - DIABETES

Question 1

A condition characterized by excessive urination (polyuria) caused by an inability of the kidney to properly resorb water from the urine.

Answer 1

Diabetes insipidus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757

Question 2

Enzyme deficient in central Diabetes insipidus.

Answer 2

Anti-diuretic hormone(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 757

Question 3

An autoimmune disease characterized by progressive destruction of islet beta cells, leading to absolute insulin deficiency.

Answer 3

Type 1 diabetes mellitus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781

Question 4

Caused by a combination of peripheral resistance to insulin action and an inadequate compensatory response of insulin secretion by the pancreatic beta cells.

Answer 4

Type 2 diabetes mellitus(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781

Question 5

Vascular lesion associated with hypertension, which is more prevalent in diabetics.

Answer 5

Hyaline arteriolosclerosis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 781

Question 6

A diffuse increase in mesangial matrix along with mesangial cell proliferation and is always associated with basement membrane thickening of the glomerulus. Seen in patients with diabetes mellitus.

Answer 6

Diffuse mesangial sclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783

Question 7

A glomerular lesion made distinctive by ball-like deposits of a laminated matrix situated in the periphery of the glomerulus .

Answer 7

Nodular glomerulosclerosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783

Question 8

The ball-like deposit seen in nodular glomerulosclerosis.

Answer 8

Kimmelstiel-Wilson lesion(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 783

Question 9

A special pattern of acute pyelonephritis seen more often in diabetics.

Answer 9

Necrotizing papillitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 784

Question 10

Most common pancreatic endocrine neoplasms.

Answer 10

beta-cell tumors (insulinomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788

Question 11

These benign tumors look remarkably like giant islets, with preservation of the regular cords of monotonous cells and their orientation to the vasculature.

Answer 11

Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788

Question 12

What syndrome is described by the association of pancreatic islet cell lesions with hypersecretion of gastric acid and severe peptic ulceration?

Answer 12

Zollinger-Ellison syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788

Question 13

Tumors associated with increased serum glucagon and a syndrome consisting of mild diabetes mellitus, a characteristic skin rash (necrolytic migratory erythema), and anemia.

Answer 13

alpha-Cell tumors (glucagonomas) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789

Question 14

Most common cause of Cushing syndrome.

Answer 14

Administration of exogenous glucocorticoids(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 789

Question 15

Components of MEN1?

Answer 15

Parathyroid: Primary hyperparathyroidismPancreas: ZES, insulinoma, etc.Pituitary: prolactin-secreting macroadenoma, somatotrophin-secreting tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 798

Question 16

Components of MEN2A?

Answer 16

Thyroid: Medullary carcinoma
Adrenal medulla: pheochromocytomas
Parathyroid: parathyroid gland hyperplasia (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799

Question 17

Components of MEN2B?

Answer 17

Thyroid: Medullary carcinoma
Adrenal medulla: pheochromocytoma
Extraendocrine manifestations: ganglioneuromas of mucosal sites (gastrointestinal tract, lips, tongue) and marfanoid habitus (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 799

Question 18

Syndrome of mild DM, characteristic rash (necrolytic migratory erythema), and anemia is seen in what tumor?

Answer 18

Glucagonomas or alpha cell tumors (TOPNOTCH)

Question 19

Syndrome of DM, cholelithiasis, steatorrhea, and hypochlorhydria is seen in what tumor?

Answer 19

Somatostatinoma or delta cell tumor (TOPNOTCH)

Question 20

Approximately 60%-80% of patients with DM will develop some form of diabetic retinopathy after how many years from the time of diagnosis?

Answer 20

15-20 years (TOPNOTCH)

Question 21

The fundamental lesion of DM retinopathy

Answer 21

neovascularization (TOPNOTCH)

Question 22

What special pattern of acute pyelonephritis is common in diabetics compared to non diabetics?

Answer 22

Necrotizing papillitis or papillary necrosis (TOPNOTCH)

Question 23

These are PAS positive glomerular lesions made distinctive by ball like deposits of laminated matrix situated in the periphery of the glomerulus

Answer 23

Nodular glomerulosclerosis or Kimmelstiel Wilson lesion (TOPNOTCH)

Question 24

What are the three most important glomerular lesions seen in DM?

Answer 24

Basement membrane thickening,
diffuse mesangial sclerosis, and
nodular glomerulosclerosis (TOPNOTCH)

Question 25

What is the hallmark of diabetic macrovascular disease?

Answer 25

Accelerated atherosclerosis (TOPNOTCH)

Question 26

What is the most common cause of death in diabetics?

Answer 26

Myocardial Infarction (TOPNOTCH)

Question 27

What morphological change seen in pancreas is more commonly associated with DM Type 2 than DM Type 1?

Answer 27

Amyloid replacement of islets (TOPNOTCH)

Question 28

Pathogenesis: Dysfunction in T cell selection and regulation leading to breakdown in self-tolerance to islet autoantigens

Answer 28

Type 1 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108

Question 29

Pathogenesis: Insulin resistance in peripheral tissues and failure of compensation by beta cells

Answer 29

Type 2 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108

Question 30

Characterized by inflammatory infiltrate of T cells and macrophages, beta cell depletion and islet atrophy

Answer 30

Type 1 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108

Question 31

Characterized by amyloid deposition in islets and mild beta cell depletion. No insulitis.

Answer 31

Type 2 diabetes mellitus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1108

Question 32

Most potent anabolic hormone with multiple synthetic and growth-promoting effects.

Answer 32

Insulin (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1109

Question 33

The most important environmenta risk factor for type 2 diabetes

Answer 33

Obesity(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1111

Question 34

The most common precipitating factor in DKA

Answer 34

Failure to take insulin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1114

Question 35

Which of the following renal histologic findings is most characteristic of diabetes? (A) focal mild pyelonephritis (B) diffuse mesangial sclerosis (C) arteriosclerosis of efferent arterioles of the glomerulus (D) crescentic glomerulonephritis

Answer 35

arteriosclerosis of the efferent arterioles of the glomerulus (TOPNOTCH)Robbins Basic Pathology, 8th ed., pp783-784

Question 36

Of the pancreatic endocrine neoplasms or islet cell tumors, which is most commonly benign? (A) insulinomas (B) gastrinomas (C) VIPomas (D) nonfunctioning islet cell tumors

Answer 36

Insulinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 788