Pathology_2 01: Diabetes Mellitus

Front 1

2 pathways triggered by insulin

Back 1

MAPK
PI3K

Front 2

MAPK causes ___ (2)

Back 2

growth
differentiation

Front 3

PI3K causes ___

Back 3

GLUT4 translocation

Front 4

95% of DM1 patients have ___ or ___

Back 4

HLA-DR3
HLA-DR4

Front 5

in early DM1, beta cells abnormally express ___

Back 5

HLA class II

Front 6

___ released by T cells and ___ released by macrophages damages beta cells

Back 6

IFNgamma
IL1
TNFa

Front 7

4 Abs present in DM1

Back 7

anti islet
anti insulin
anti glutamic acid decarboxylase (GAD)
anti bovine serum albumin (BSA)

Front 8

DM1 and DM2 are both ___ diabetes

Back 8

primary (idiopathic)

Front 9

2 kinds of secondary diabetes
___ is more common

Back 9

pancreatic dysfunction
endocrine (?)
endocrine

Front 10

secondary diabetes is common/rare

Back 10

rare

Front 11

6 viruses associated with DM1

Back 11

rubella
coxsackie
mumps
measles
CMV
EBV

Front 12

cow milk can cause DM1 because an autoimmune ___ occurs between ___ and ___

Back 12

cross reaction
BSA
beta cell p69

Front 13

in DM2, although concordance between identical twins is ___%, there is no ___

Back 13

50-90
HLA association

Front 14

T/F: in DM2 insulin levels eventually reach 0

Back 14

false

Front 15

insulin resistance in DM2 is due to reduced function and number of ___ (2)

Back 15

insulin receptors
GLUT4

Front 16

reduced insulin secretion in DM2 is due to reduced function and number of ___

Back 16

beta cell GLUT2

Front 17

late in DM2 ___ is present in beta cells

Back 17

amyloid

Front 18

complications of DM depend on ___ and ___ of hyperglycemia

Back 18

duration
severity

Front 19

3 mechanisms of DM complications

Back 19

non-enzymatic glycation
aldose reductase
PKC activation

Front 20

T/F: non-enzymatic glycation is irreversible

Back 20

true

Front 21

non-enzymatic glycation forms ___s

Back 21

advanced glycation end-products (AGE)

Front 22

the main problem with AGEs is ___

Back 22

they resist proteolysis

Front 23

AGEs bind ___ in the arterial ___. this causes ___

Back 23

LDLs
intima
increased atherosclerosis

Front 24

in small vessels AGEs cause ___, which causes ___

Back 24

increased BM collagen 4
microangiopathy

Front 25

aldose reductase converts ___ to ___. it is present in ___

Back 25

glucose
sorbitol
Schwann cells
retinal capillary pericytes
lens

Front 26

in DM, activation of aldose reductase in Schwann cells causes ___, in retinal capillaries causes ___, and in lens causes ___.

Back 26

neuropathy
retinal microaneurysms
cataracts

Front 27

in DM activation of PKC causes release of ___, which causes ___ (2)

Back 27

VEGF
increased BM deposition
increased tPAI

Front 28

complications of DM take ___ years to develop and depend on ___

Back 28

10-15
severity of hyperglycemia

Front 29

6 DM complications

Back 29

capillary BM thickening
accelerated atherosclerosis
ocular (retinopathy)
neuropathy
renal
infections

Front 30

capillary BM thickening is aka ___ and causes ___

Back 30

microangiopathy
ischemia
proteinuria

Front 31

protein leakage in DM is due to increased ___ and decreased ___

Back 31

BM collagen 4
polyanionic proteoglycans

Front 32

DM causes ___fold increase in MI risk. the increase is higher/lower in women of reproductive age

Back 32

2.5
hgher

Front 33

DM causes ___fold increase in risk of blindness.

Back 33

20

Front 34

2 kinds of DM retinopathy

Back 34

nonproliferative
proliferative

Front 35

earliest change to appear in nonproliferative retinopathy is characterized by ___, which is identified via ___. later changes are

Back 35

capillary leakage
fluorescein angiography
capillary obstruction
microaneurysm

Front 36

___ are pathognomonic for DM and are present in all patients with ___

Back 36

retinal microaneurysms
nodular GS

Front 37

in proliferative retinopathy ____s grow ___ly into ___. this can cause ___ and ___

Back 37

blood vessels
anterior
vitreous humor
retinal detachment
blindness

Front 38

tx for both kinds of retinopathy

Back 38

photocoagulation of vessels

Front 39

2 kinds of DM neuropathy

Back 39

symmetric peripheral
autonomic

Front 40

symmetric peripheral neuropathy causes ___ and ___ defects

Back 40

sensory
motor

Front 41

tendency for infection is due to ___ (2)

Back 41

leukocyte dysfunction
vascular disease

Front 42

pancreatic change in late DM2

Back 42

amyloidosis

Front 43

amyloid in DM2 is ___, a protein normally secreted by ___

Back 43

amylin
beta cells