Pathophysiology exam 3 UNMC fall
what is diabetes Mellitus (DM)? - ANS-a systemic metabolic disorder in which there is
chronic hyperglycemia (high blood sugar over years)
what are 2 causes of diabetes mellitus? - ANS-1. a decrease in production and
secretion of insulin (type 1)
2. a decrease in the cells ability to utilize the insulin (type 2)
insulin deficiency can lead to... - ANS-impaired use of CHO, fats, and proteins
chronic hyperglycemia causes... - ANS-structural abnormalities in (the vasculature of)
many organs
where is insulin produced? - ANS-beta cells of islets of Langerhans in pancreas
Where are tyrosine kinase receptors located in the cell? - ANS-the body of the cell
what is GLUT 4? - ANS-glucose transporter protein 4
what is the average age of onset for type 1 diabetes? - ANS-usually before 30
what is the average age of onset for type 2 diabetes? - ANS-usually after 30 (but
trending down)
what are the clinical manifestations of diabetes mellitus? - ANS-polyuria, polydipsia,
polyphagia, weight loss, weakness, fatigue
how is diabetes mellitus diagnosed? - ANS--FBS > 126 mg/dl
-presence of islet cell antibodies
-glycosylated hemoglobin > 5.5%
-glucose tolerance test
what is gluceneogensis? - ANS-the liver makes glycogen from fats and/or proteins
what is glycogenolysis? - ANS-breakdown of stored glucose/glycogen stores to provide
blood glucose
, what is diabetic ketoacidosis? - ANS-(diabetic coma); extreme hyperglycemia;
hyperglycemia of 300-800 mg/dl with ketonuria
what is ketonuria? - ANS-ketones in the urine
what are the etiologies of diabetic ketoacidosis? - ANS--not enough insulin
-illness
-psychologic stress
what does a decrease in insulin lead to? - ANS--decreased glucose transport into the
cell, which leads to the body sensing the low cellular glucose (but still high in the blood
stream), this then leads to glycogenolysis and gluconeogenesis (which makes the
problem worse)
why does polyuria and polydipsia occur in diabetics? - ANS-the high blood sugar leads
to osmotic diuresis which leads to dehydration causing an intake of fluids
why does ketonuria occur in diabetic ketoacidosis? - ANS-increased lipolysis
(breakdown of fats) causes ketone production and accumulation which leads to
ketonuria and acidosis
what does acidosis lead to? - ANS-hyperkalemia
what are the clinical manifestations of diabetic ketoacidosis? - ANS-1. hyperglycemia
2. ketonuria
3. polyuria, polydipsia, polyphagia
4. N/V, abdominal pain
5. kussmaul's respirations (fast, hard, deep)
6. can lead to hypotension, tachycardia, shock, cardiac arrhythmias
what is hypoglycemia? - ANS-low blood sugar (less than 60 mg/dl)
what are the etiologies of hypoglycemia? - ANS-overdose of insulin
what are the clinical manifestations of hypoglycemia? - ANS-1. neurogenic reaction
when the hypothalamus senses decreased glucose levels: increased HR,RR, and
diaphoresis, pallor, tremors, cool skin
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