ADVANCED PATHOPHYSIOLOGY EXAM 2 -
WITH 100% ACCURATE SOLUTIONS
What type of Diabetes is also called 'Juvenile diabetes,' and is an autoimmune disorder resulting
from genetics, environmental trigger, hypersensitivity reaction?
Type 1 Diabetes Mellitus
Which type of Diabetes involves the destruction of pancreatic beta cells and results in an absolute
deficiency of insulin?
Type 1 Diabetes Mellitus
Which type of Diabetes involves insulin resistance where the effect of insulin is blunted in skeletal
muscle and liver?
Type 2 Diabetes Mellitus
Which type of Diabetes involves progressive impairment of beta cells, deranged secretion of insulin,
or the eventual exhaustion/failure of beta cells, and increased glucose production by liver?
Type 2 Diabetes Mellitus
The following risk factors are for what disease?
-Family history
-Overweight
-Sedentary lifestyle
-Cardiovascular disease
-Hypertension
-Polycystic Ovary Syndrome
-Psychiatric Illness
-Latino/Hispanic, Black, Asian American, Native American, or Pacific Islander decent
-History of delivering infant >9 Ibs.
Type 2 Diabetes Mellitus
What is the pathophysiology of Type 2 Diabetes Mellitus?
Regardless of cause,
1. pancreatic beta cells have decreased release of insulin (leads to decreased glucose uptake AND
increased hepatic glucose output and eventual hyperglycemia).
2. Skeletal muscle has increased insulin resistance (leads to decreased glucose uptake, and eventual
hyperglycemia).
The following risk factors are for what disease?
-Family history
-Beta cell autoimmunity
-Autoimmune disease
-Infection
,-Environmental exposure
-Chemical exposure
-Dietary exposure
Type 1 Diabetes Mellitus
The following risk factors are for what disease?
-Family history
-History of stillbirth or spontaneous abortion
-Fetal abnormalities in previous pregnancy
-Previous heavy infant
-Obese
-Advanced maternal age
-Greater than or equal to 5 pregnancies
Gestational Diabetes Mellitus
Which disease has the following presentation?
-Abdominal obesity
-Increased free fatty acids
-Beta cell dysfunction
-Insulin resistance
-Overproduction of glucose by liver
Metabolic Syndrome
What is the NCEP ATP III Criteria for diagnosis of Metabolic Syndrome?
-Abdominal obesity: waist >35 in. in women, >40 in. in men
-Triglycerides > or equal to 150 mg/dL
-HDL <50 mg/dL in women, <40 mg/dl in men
-Blood pressure >130/85
-Fasting plasma glucose >100 mg/dL
Which disease has the following signs and symptoms?
-Excess glucose not reabsorbed/water loss
-Intracellular dehydration
-Cellular starvation
-Osmotic diuresis, fat, and protein used for energy*
-Lens and retina exposed to hyperosmotic fluid
-Temporary dysfunction of peripheral nerves
Diabetes Mellitus
*Osmotic diuresis, fat, and protein used for energy (ONLY for TYPE 1 DM)
When should individuals get tested for diabetes?
All individuals 45 years and older.
Below 45 years old if:
-1st degree relative has DM
-Obese
-physical inactivity
-High risk ethnic population
,-Women with PCOS
-Have HTN, HLP, or CVD
What are 3 diagnostic tests for Diabetes?
-Fasting blood glucose test
-Oral glucose tolerance test
-HbA1c test
How long must one fast in the fasting blood glucose test?
8 hours
What is the normal and impaired ranges for the fasting blood glucose test?
Normal: <100 mg/dL
Impaired: 100-125 mg/dL
What is the normal and impaired ranges for the Oral glucose tolerance test?
Normal: <140 mg/dL
Impaired: 140-199 mg/dL
True or false? Glucose entry into RBC is not insulin dependent.
True
According to the ADA criteria, what is the diagnostic reading of HbA1c for diabetes?
greater than or equal to 6.5%
*Note the ADA does not have this diagnostic criteria for gestational diabetes
According to the ADA criteria, what is the diagnostic reading of fasting plasma glucose for diabetes?
greater than or equal to 126 mg/dL
According to the ADA criteria, what is the diagnostic reading of the Oral Glucose Tolerance Test for
diabetes?
greater than or equal to 200 mg/dL
What are the 3 acute complications of Diabetes Mellitus?
1. Diabetic Ketoacidosis (DKA)
2. Hypoglycemia
3. Hyperosmolar Hyperglycemia State (HHS)
Which acute complication of Diabetes Mellitus presents in the following way?
-Blood glucose 250-600 mg/dL
-Dehydration
-Acidotic
-Nausia/Confusion
-Insulin deficiency
Diabetic Ketoacidosis (DKA)
, Which acute complication of Diabetes Mellitus presents in the following way?
-Blood glucose >600 mg/dL
-Osmotic diuresis and dehydration
-Non-acidotic, no ketones
-Relative insulin deficiency
Hyperosmolar Hyperglycemia State (HHS)
Which acute complication of Diabetes Mellitus presents in the following way?
-Blood glucose <70 mg/dL
Hypoglycemia
What are 3 general systems affected by chronic complication of Diabetes Mellitus?
1. Impaired Immune System
2. Microvascular
3. Macrovascular
Name 3 common Microvascular chronic complications from Diabetes Mellitus.
1. Retinopathy (Eye)
2. Nephropathy (Kidney)
3. Neuropathy (Nerves)
Name 3 common Macrovascular chronic complications from Diabetes Mellitus.
1. Coronary artery disease (MI)
2. Peripheral vascular disease (Atherosclerosis)
3. Cerebrovascular disease (Stroke)
What is the Somogyi effect?
An episode of Insulin induced hypoglycemia that occurs overnight.
What is the Dawn phenomenon?
Increased fasting blood glucose episode in the morning. Without prior hypoglycemia.
Interference with outflow of blood and interference with removal of waste are characteristic of
venous or arterial disorders?
Venous disorders
What is the etiology of venous thrombi?
-Stasis of blood
-Activation of clotting cascade (fibrin complex)
What is the etiology of arterial thrombi?
-Turbulence of blood
-Platelet aggregation
Is endothelial dysfunction reversible or irreversible?
Reversible
WITH 100% ACCURATE SOLUTIONS
What type of Diabetes is also called 'Juvenile diabetes,' and is an autoimmune disorder resulting
from genetics, environmental trigger, hypersensitivity reaction?
Type 1 Diabetes Mellitus
Which type of Diabetes involves the destruction of pancreatic beta cells and results in an absolute
deficiency of insulin?
Type 1 Diabetes Mellitus
Which type of Diabetes involves insulin resistance where the effect of insulin is blunted in skeletal
muscle and liver?
Type 2 Diabetes Mellitus
Which type of Diabetes involves progressive impairment of beta cells, deranged secretion of insulin,
or the eventual exhaustion/failure of beta cells, and increased glucose production by liver?
Type 2 Diabetes Mellitus
The following risk factors are for what disease?
-Family history
-Overweight
-Sedentary lifestyle
-Cardiovascular disease
-Hypertension
-Polycystic Ovary Syndrome
-Psychiatric Illness
-Latino/Hispanic, Black, Asian American, Native American, or Pacific Islander decent
-History of delivering infant >9 Ibs.
Type 2 Diabetes Mellitus
What is the pathophysiology of Type 2 Diabetes Mellitus?
Regardless of cause,
1. pancreatic beta cells have decreased release of insulin (leads to decreased glucose uptake AND
increased hepatic glucose output and eventual hyperglycemia).
2. Skeletal muscle has increased insulin resistance (leads to decreased glucose uptake, and eventual
hyperglycemia).
The following risk factors are for what disease?
-Family history
-Beta cell autoimmunity
-Autoimmune disease
-Infection
,-Environmental exposure
-Chemical exposure
-Dietary exposure
Type 1 Diabetes Mellitus
The following risk factors are for what disease?
-Family history
-History of stillbirth or spontaneous abortion
-Fetal abnormalities in previous pregnancy
-Previous heavy infant
-Obese
-Advanced maternal age
-Greater than or equal to 5 pregnancies
Gestational Diabetes Mellitus
Which disease has the following presentation?
-Abdominal obesity
-Increased free fatty acids
-Beta cell dysfunction
-Insulin resistance
-Overproduction of glucose by liver
Metabolic Syndrome
What is the NCEP ATP III Criteria for diagnosis of Metabolic Syndrome?
-Abdominal obesity: waist >35 in. in women, >40 in. in men
-Triglycerides > or equal to 150 mg/dL
-HDL <50 mg/dL in women, <40 mg/dl in men
-Blood pressure >130/85
-Fasting plasma glucose >100 mg/dL
Which disease has the following signs and symptoms?
-Excess glucose not reabsorbed/water loss
-Intracellular dehydration
-Cellular starvation
-Osmotic diuresis, fat, and protein used for energy*
-Lens and retina exposed to hyperosmotic fluid
-Temporary dysfunction of peripheral nerves
Diabetes Mellitus
*Osmotic diuresis, fat, and protein used for energy (ONLY for TYPE 1 DM)
When should individuals get tested for diabetes?
All individuals 45 years and older.
Below 45 years old if:
-1st degree relative has DM
-Obese
-physical inactivity
-High risk ethnic population
,-Women with PCOS
-Have HTN, HLP, or CVD
What are 3 diagnostic tests for Diabetes?
-Fasting blood glucose test
-Oral glucose tolerance test
-HbA1c test
How long must one fast in the fasting blood glucose test?
8 hours
What is the normal and impaired ranges for the fasting blood glucose test?
Normal: <100 mg/dL
Impaired: 100-125 mg/dL
What is the normal and impaired ranges for the Oral glucose tolerance test?
Normal: <140 mg/dL
Impaired: 140-199 mg/dL
True or false? Glucose entry into RBC is not insulin dependent.
True
According to the ADA criteria, what is the diagnostic reading of HbA1c for diabetes?
greater than or equal to 6.5%
*Note the ADA does not have this diagnostic criteria for gestational diabetes
According to the ADA criteria, what is the diagnostic reading of fasting plasma glucose for diabetes?
greater than or equal to 126 mg/dL
According to the ADA criteria, what is the diagnostic reading of the Oral Glucose Tolerance Test for
diabetes?
greater than or equal to 200 mg/dL
What are the 3 acute complications of Diabetes Mellitus?
1. Diabetic Ketoacidosis (DKA)
2. Hypoglycemia
3. Hyperosmolar Hyperglycemia State (HHS)
Which acute complication of Diabetes Mellitus presents in the following way?
-Blood glucose 250-600 mg/dL
-Dehydration
-Acidotic
-Nausia/Confusion
-Insulin deficiency
Diabetic Ketoacidosis (DKA)
, Which acute complication of Diabetes Mellitus presents in the following way?
-Blood glucose >600 mg/dL
-Osmotic diuresis and dehydration
-Non-acidotic, no ketones
-Relative insulin deficiency
Hyperosmolar Hyperglycemia State (HHS)
Which acute complication of Diabetes Mellitus presents in the following way?
-Blood glucose <70 mg/dL
Hypoglycemia
What are 3 general systems affected by chronic complication of Diabetes Mellitus?
1. Impaired Immune System
2. Microvascular
3. Macrovascular
Name 3 common Microvascular chronic complications from Diabetes Mellitus.
1. Retinopathy (Eye)
2. Nephropathy (Kidney)
3. Neuropathy (Nerves)
Name 3 common Macrovascular chronic complications from Diabetes Mellitus.
1. Coronary artery disease (MI)
2. Peripheral vascular disease (Atherosclerosis)
3. Cerebrovascular disease (Stroke)
What is the Somogyi effect?
An episode of Insulin induced hypoglycemia that occurs overnight.
What is the Dawn phenomenon?
Increased fasting blood glucose episode in the morning. Without prior hypoglycemia.
Interference with outflow of blood and interference with removal of waste are characteristic of
venous or arterial disorders?
Venous disorders
What is the etiology of venous thrombi?
-Stasis of blood
-Activation of clotting cascade (fibrin complex)
What is the etiology of arterial thrombi?
-Turbulence of blood
-Platelet aggregation
Is endothelial dysfunction reversible or irreversible?
Reversible
