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28 Cards in this Set
- Front
- Back
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172. Diabetic Nephropathy features (from nonenzymatic glycosylation)?!? know this well
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a. Nodular sclerosis!
b. Progressive proteinuria c. Chronic renal failure d. Arteriosclerosis leading to HTN e. Kimmelstiel-Wilson nodules!!!! |
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173. Complications of large vessel atherosclerosis from nonenzymatic glycosylation in DM?
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a. CAD
b. Peripheral vascular occlusive disease c. Gangrene -> limb loss d. Cerebrovascular disease |
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174. Osmotic damage from DM?
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a. Neuropathy (motor, sensory, autonomic degeneration)
b. Cataracts (sorbitol accumulation)!! |
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176. Genetic predisposition for DM I?
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a. Weak, polygenic.
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177. HLA associated w/DMI (none for DMII)?
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a. HLA- DR3 and 4.
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178. β-cells in islets w/ DMI vs. DM II?
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a. DMI ↓
b. DM II- Variable (with amyloid deposits) |
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179. Histology of DM I vs. DM II?
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a. DM I- Islet leukocytic infiltrate.
b. DM II- Islet amyloid deposit. |
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180. Diabetic ketoacidosis: cause?
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a. Usually due to ↑ insulin requirements from ↑ stress (e.g. infection).
b. Excess fat breakdown and ↑ ketogenesis from ↑ FFA, which are then made into ketone bodies. |
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181. Ketone body ratio in diabetic ketoacidosis?!?! (This was a Kaplan question)?
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a. β-hydroxybutyrate > acetoacetate). Normally it’s the other way around.
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182. Signs/sx of DKA?
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a. Kussmaul breathing (rapid/deep breathing)
b. N/V c. Abdominal pain d. Psychosis/delirium e. Dehydration f. Fruity odour on breath (due to exhaled acetone). |
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183. Complications of DKA?
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a. Life-threatening mucormycosis!!
b. Rhizopus infection c. Cerebral oedema d. Cardiac arrhythmias e. Heart failure. |
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184. Tx of DKA?
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a. Fluids
b. Insulin c. K+!!!!! To replete intracellular stores. This is key, even if their potassium is borderline high, when you give them insulin its going to drive the potassium into cells risking hypokalemia. d. Glucose if necessary to prevent hypoglycemia. |
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185. Carcinoid syndrome: type of cells?
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a. Neuroendocrine cells of GI tract
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186. What type of Carcinoid is likely to secrete ↑ 5-HT?
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a. Metastatic small bowel tumours.
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187. Carcinoid most likely to met and most common?
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a. Distal ileum is most likely to met but appendix is most common.
b. Carcinoid syndrome is not seen if tumour is limited to GI tract (5-HT undergoes first-pass metabolism in liver). c. Carcinoid in the appendix usually doesn’t spread because it causes appendicitis and is picked up before it spreads. d. It is also the most common tumour of the appendix. |
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188. Carcinoid syndrome?
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a. Recurrent:
1. Diarrhoea 2. Cutaneous flushing 3. Asthmatic wheezing 4. Right-sided heart failure (remember 5-HT is broken down by MOA in lungs). If its on the left side of the heart, then it means there are lung mets. |
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189. What causes the heart failure in carcinoid?
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a. Serotonin causes fibrosis of the heart.
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190. Rule of 1/3 with carcinoid tumours?
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a. 1/3 met
b. 1/3 present w/2nd malignancy c. 1/3 multiple |
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191. Treatment for Carcinoid syndrome!?!?
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a. Octreotide- (synthetic somatostatin).
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192. Zollinger-Ellison syndrome: also stomach morph, and with what condition may it be associated?
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a. Gastrin-secreting tumour of pancreas or duodenum.
b. Stomach may show rugal thickening w/acid hypersecretion. c. May be associated with MEN I |
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193. What is MEN I aka?
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a. Wermer’s syndrome.
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194. MEN I (Wermer’s syndrome) characteristics?
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a. Parathyroid tumours
b. Pituitary tumours (prolactin or GH) c. Pancreatic endocrine tumours- Zollinger-Ellison syndrome, insulinomas, VIPomas, glucagonomas (rare). d. “3 Ps” |
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195. How does MEN I commonly present?
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a. Commonly presents with kidney stones and stomach ulcers.
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196. What is MEN 2A aka?
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a. Sipple’s syndrome.
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197. MEN 2A (Sipple’s syndrome) characteristics?
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a. Medullary thyroid carcinoma (secretes calcitonin)
b. Pheochromocytoma c. Parathyroid tumours d. “2 Ps” and an M. |
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198. MEN 2B characteristics?
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a. Medullary thyroid carcinoma (secretes calcitonin)
b. Pheochromocytoma c. Oral/intestinal ganglioneuromatosis d. (marfanoid habitus) e. “1 P” |
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199. Inheritance type of all MEN syndromes?
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a. Autosomal dominant!
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200. With what gene are MEN2A and 2B associated/w?!?
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a. Ret proto-oncogene.
b. Receptor for tyrosine kinase. c. Re +T =Receptor Tyrosine kinase. |
