Diabetes and Pregnancy: Acanthosis Nigricans and Insulin Resistance
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Questions and Answers

What is a mechanism implicated in the deleterious effects of persistent hyperglycemia on peripheral tissues?

  • Enhanced insulin secretion
  • Increased glucose uptake
  • Formation of advanced glycation end products (correct)
  • Activation of mTOR pathway
  • Which process involves the generation of fructose-6-phosphate in relation to persistent hyperglycemia?

  • Oxidative phosphorylation
  • Activation of protein kinase C
  • Krebs cycle
  • Hexosamine pathways (correct)
  • What is a characteristic feature of diabetic macrovascular disease?

  • Decreased aneurysms
  • Decreased atherosclerosis
  • Enhanced vascular function
  • Accelerated atherosclerosis (correct)
  • In Type 2 Diabetes, what may be observed related to islet cell mass?

    <p>Subtle reduction in islet cell mass</p> Signup and view all the answers

    Which condition is about 100 times more common in diabetes patients than in the general population?

    <p>Gangrene of lower extremities</p> Signup and view all the answers

    What causes myocardial infarction in diabetes?

    <p>Atherosclerosis of the coronary arteries</p> Signup and view all the answers

    What leads to amyloid deposition within islets in Type 2 Diabetes?

    <p>Amylin aggregation</p> Signup and view all the answers

    What skin manifestation is commonly seen in patients with type A insulin resistance?

    <p>Acanthosis nigricans</p> Signup and view all the answers

    What is the term used to describe women who were previously euglycemic but develop impaired glucose tolerance and diabetes for the first time during pregnancy?

    <p>Gestational diabetes</p> Signup and view all the answers

    What is a potential risk for newborns of mothers with poorly controlled diabetes later in pregnancy?

    <p>Macrosomia</p> Signup and view all the answers

    During the 'honeymoon period' following overt Type 1 diabetes, what characterizes the initial 1 or 2 years?

    <p>Residual endogenous insulin secretion</p> Signup and view all the answers

    What characteristic age group is typically associated with Type 2 diabetes?

    <p>Older than 40 years</p> Signup and view all the answers

    What symptoms might prompt obese individuals over 45 years to seek medical attention for possible diabetes?

    <p>Unexplained fatigue, dizziness, or blurred vision</p> Signup and view all the answers

    What is the main concern for individuals with poor control of diabetes later in pregnancy?

    <p>Increased risk of obesity and diabetes in the child</p> Signup and view all the answers

    'Gestational' diabetes occurs when women who were previously euglycemic develop what condition during pregnancy?

    <p>'Impaired glucose tolerance and diabetes'</p> Signup and view all the answers

    What is a characteristic feature of many insulinomas?

    <p>Deposition of amyloid</p> Signup and view all the answers

    What percentage of islet cell tumors demonstrate excessive insulin secretion?

    <p>80%</p> Signup and view all the answers

    What is a critical laboratory finding in insulinomas?

    <p>High circulating levels of insulin</p> Signup and view all the answers

    What is usually followed by prompt reversal of the hypoglycemia in cases of insulinomas?

    <p>Surgical removal of the tumor</p> Signup and view all the answers

    Which type of tumors make up only about 10% of cases?

    <p>Carcinomas</p> Signup and view all the answers

    In how many cases does hypoglycemia become clinically symptomatic?

    <p>About 20%</p> Signup and view all the answers

    What is a common size characteristic of solitary tumors?

    <p>$&lt;5$ cm</p> Signup and view all the answers

    What feature helps diagnose Bona fide carcinomas?

    <p>Local invasion and distant metastases</p> Signup and view all the answers

    What is the characteristic feature of Nodular Glomerulosclerosis under microscopy?

    <p>Ovoid or spherical PAS-positive nodules in the periphery of the glomerulus</p> Signup and view all the answers

    Which type of Glomerulosclerosis is also known as Kimmelstiel-Wilson Disease?

    <p>Nodular Glomerulosclerosis</p> Signup and view all the answers

    What is the most profound ocular complication of diabetes according to the text?

    <p>Retinal detachment</p> Signup and view all the answers

    Which type of matrix deposits are PAS-positive in Diffuse Mesangial Sclerosis?

    <p>Mesangial matrix deposits</p> Signup and view all the answers

    What is the main effect of diabetes-induced hyperglycemia on the lens of the eye?

    <p>Acquired opacification</p> Signup and view all the answers

    Which of the following is NOT a characteristic finding of Nodular Glomerulosclerosis?

    <p>Linear PAS-negative deposits throughout the glomerulus</p> Signup and view all the answers

    What is the primary mechanism through which Glaucoma affects vision in diabetic patients?

    <p>Optic nerve damage from increased intraocular pressure</p> Signup and view all the answers

    What is the key feature of Glomerular lesions in Nodular Glomerulosclerosis?

    <p>&quot;Fibrin caps&quot; in capillary loops</p> Signup and view all the answers

    Which type of adrenal cortical hyperplasia is much less common than ACTH-dependent adrenal cortical hyperplasia?

    <p>Primary cortical hyperplasia</p> Signup and view all the answers

    What is the size of the nodules typically seen in bilateral macronodular adrenal hyperplasia (BMAH)?

    <p>Greater than 10 mm in diameter</p> Signup and view all the answers

    Which gene mutation is commonly associated with micronodular adrenal hyperplasia?

    <p>PRKAR1A gene mutation</p> Signup and view all the answers

    What is the characteristic morphology change observed in ACTH-producing cells of the anterior pituitary in Crooke hyaline change?

    <p>Cytoplasm becomes homogeneous and paler</p> Signup and view all the answers

    In which condition do germline mutations activate the GNAS gene, leading to a multisystemic disease?

    <p>Mccune-Albright syndrome</p> Signup and view all the answers

    Which type of Cushing syndrome is characterized by high levels of cortisol with low levels of ACTH?

    <p>ACTH-independent Cushing syndrome</p> Signup and view all the answers

    What is the main alteration observed in the pituitary and adrenal glands due to high levels of glucocorticoids?

    <p>Crooke hyaline change</p> Signup and view all the answers

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