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Pathology 2 - Block 3 - Part 6

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davidwurbel7's version from 2016-07-31 22:59

Pancreas

Question Answer
Insulin is secreted by beta cells, which lie here within the islets of LangerhansCenter of Islets
Absolute or relative deficiency of insulin resulting in under-utilization of glucose and hyperglycemiaDiabetes Mellitus
Due to autoimmune destruction of beta cells by T lymphocytes. Depletion or absence of beta cells resulting in. Severe insulin deficiency. Associated with HLA-DR-3 and DR-4. Autoantibodies against insulin are often presentDM Type I
Clinical features include high serum glucose, weight loss, low muscle mass, polyphagia, polyuria, polydipsia and glycosuriaDM Type I
Presents with Anion gap metabolic acidosis and hyperkalemia, Kussmaul respirations, dehydration, nausea , vomiting, hyperglycemia, mental status changes and fruity smelling breathDiabetic Ketoacidosis
Treatment includes Fluids, Insulin and Replacement of electrolytesDiabetic Ketoacidosis
Due to end organ resistance to insulin leading to a metabolic disorder characterized by hyperglycemiaDM Type II
Insulin deficiency develops due to beta cell exhaustionDM Type II
Amyloid deposition in the isletsDM Type II
T cell infiltration into the isletsDM Type I
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Question Answer
Random glucose>200 mg/dl
Fasting glucose>126 mg/dl
Glucose tolerance test with a serum glucose level two hours after glucose loading>200 mg/dl
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Question Answer
High glucose (>500mg/dl) leads to life threatening diuresis with hypotension and comaHyperosmolar Non-Ketotic Coma
Treatment includes fluid replacement and insulin IV?Hyperosmolar Non-Ketotic Coma
Glucose combines with amino groups in proteins of blood vessel basement membraneNonenzymatic Glycosylation (NEG)
NEG of large and medium sized vessels results in this and its resultant complicationsAtherosclerosis
The leading cause of non-traumatic amputation due to gangrenePeripheral Vascular Disease
Involvement of efferent arterioles eventually leads to nephrotic syndrome which then leads this which is characterized by Kimmelstiel – Wilson nodules in glomeruliRenal Failure
Small scarred kidneys with a granular surfaceGlomerulosclerosis
This is the first sign of kidney damage in person DMMicroalbuminuria
This patient is losing more than 3.5 g of protein in their urineNephrotic Syndrome
NEG of small blood vessels (arterioles) leads to this of the arteriesHyaline Arteriolosclerosis
A marker of glycemic control. Represents mean glucose value for the preceding 8 to 12 weeks. Ideal is 6% to 7%Glycated Hb (HbA1c)
This enzyme converts glucose to sorbitol. Sorbitol draws water into cells causing osmotic damageAldose Reductase
Aldose Reductase convert glucose to thisSorbitol
Sorbitol in the lens of the eye pulls water into the lens which leads to thisCataract
The first sense lost in diabetic neuropathy is thisVibration
Peripheral neuropathy leads to this do patients not being able feel painNeuropathic Pressure Ulcers (foot ulcers)
UUTI can lead to pyelonephropathy which causes the sluffing of the renal papillae into the ureter much like a renal stoneRenal Papillae Necrosis
Fungal infection of the orbit that can puncture into the brain infection the frontal lobeRhinocerebral mucormycosis
Non-septate broad hyphae with irregular branchingMucor
Hyperglycemia in fetus leads to increased insulin release leads to increased fat stores in adipose tissue. Insulin increases muscle mass by increasing amino acid uptake in muscleMacrosomia
Refers to glucose intolerance that first develops during pregnancy due to the anti-insulin effect of human placental lactogen (HPL), cortisol and progesteroneGestational Diabetes Mellitus
Benign tumor arising from beta islet cells. Most common tumor. 80% have MEN I syndrome. Tumor cells secrete excess insulinInsulinoma
Presents as episodic hypoglycemia with CNS dysfunction related to hypoglycemia (confusion, anxiety, stupor, convulsion, coma) that are relieved by glucose administrationInsulinoma
This is diagnosed by Low serum glucose levels (<50mg/dl), Increased insulin and Increased C- peptideInsulinoma
Malignant islet cell tumor arising from G cell in pancreas. Excess of gastrin leads to hyperacidity and peptic ulcer disease. Association with MEN I syndromeGastrinoma
Clinical findings include treatment resistant peptic ulcer. Single ulcer in the usual location in most cases. Multiple ulcers can also occur. Ulcer is in unusual place ( jejunum), Abdominal pain from PUD, Diarrhea: malabsorption, since enzymes can not work in acidic pHGastrinoma
Malignant tumor of alpha islet cellsGlucagonoma
Clinical findings include hyperglycemia and rashGlucagonoma
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