Podcast
Questions and Answers
What is the primary cause of insulin-dependent diabetes mellitus?
What is the primary cause of insulin-dependent diabetes mellitus?
Which of the following correctly describes the urine examination findings in diabetes mellitus?
Which of the following correctly describes the urine examination findings in diabetes mellitus?
What is a common laboratory finding in G6PD deficiency?
What is a common laboratory finding in G6PD deficiency?
In Von Gierke disease, which of the following metabolic disturbances is primarily observed?
In Von Gierke disease, which of the following metabolic disturbances is primarily observed?
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What is the threshold blood glucose level for diagnosing diabetes mellitus using fasting blood glucose (FBG)?
What is the threshold blood glucose level for diagnosing diabetes mellitus using fasting blood glucose (FBG)?
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Which factor is primarily responsible for the accumulation of ketone bodies in diabetic ketoacidosis?
Which factor is primarily responsible for the accumulation of ketone bodies in diabetic ketoacidosis?
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What role does hepatic fructokinase play in fructose metabolism?
What role does hepatic fructokinase play in fructose metabolism?
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What is a common treatment option for patients experiencing ketoacidosis?
What is a common treatment option for patients experiencing ketoacidosis?
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Study Notes
Diabetes Mellitus
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Types:
- Type II (85%): Peripheral tissue resistance to insulin's action, often linked to obesity. Glucose cannot enter cells without insulin.
- Type I (15%): Autoimmune destruction of insulin-producing beta cells in the pancreas. Environmental factors like viral infections may be involved.
- Type II often due to pancreatic disease (Cushing's syndrome, abnormal insulin receptor function)
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Diagnosis (Urine Examination):
- Glycosuria: Glucose presence in urine indicates elevated blood glucose levels (>10 mmol/L).
- Ketones: Accumulation of ketone bodies (acetone, acetoacetate, B-hydroxybutyrate) in urine or blood points to ketoacidosis. This happens when no insulin is present, leading to increased lipid/protein breakdown and impaired glucose entry into cells.
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Diagnosis (Blood Glucose Levels):
- Measurement: Use tubes with fluoride (glycolysis inhibitors) and glucose oxidase enzyme strips.
- Fasting Blood Glucose (FBG): Better for diagnosis than Random Blood Glucose (RBG).
- Normal FBG: < 6 mmol/L
- Borderline FBG: 6-8 mmol/L
- Diabetic FBG: > 8 mmol/L
- Oral Glucose Tolerance Test: Increased glucose level (>11 mmol/L) after 2 hours indicates diabetes.
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Treatment:
- Increased fluid intake (especially crucial in ketoacidosis).
- Insulin injections or hypoglycemic tablets.
G6PD Deficiency
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Mechanism:
- Impairment of the pentose phosphate pathway affects G6P oxidation.
- Reduced NADPH production by red blood cells leads to a lack of glutathione reduction.
- This results in uncontrolled free radical damage and red blood cell membrane breakdown (hemolysis.)
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Diagnosis:
- Microscopic: Observe Heinz bodies (abnormal structures) and red blood cell fragmentation.
- Quantitative Assay: Measure NADP+ to NADPH conversion using a spectrophotometer.
- Screening: Use fluorescent procedures.
Von Gierke Disease
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Mechanism:
- Glycogen storage abnormality; restricted glucose release.
- Inefficient lactate use in response to glucagon stimulation.
- Increased purine breakdown in the liver.
- Genetic defects affect glucose-6-phosphatase and glucose-6-translocase in liver, kidneys, and intestines.
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Symptoms:
- Hypoglycemia
- Hyperlipidemia
- Hyperuricemia (gout)
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Treatment:
- Constant carbohydrate intake throughout the day.
Fructosuria (Hepatic Fructokinase Deficiency)
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Mechanism:
- Hepatic fructokinase (ketohexokinase), the first enzyme in fructose metabolism, is deficient.
- Fructose from the diet cannot be processed properly, leading to accumulation.
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Metabolic Pathways Affected:
- Impact on fructose metabolism pathways, though not specified detailed pathway disruptions. Glycine – Arginine | Alanine – Threonine.
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Description
This quiz covers the key aspects of Diabetes Mellitus, including its two main types and their characteristics. You'll learn about the diagnostic methods for diabetes, including urine and blood glucose analysis. Test your knowledge on how diabetes affects insulin and glucose metabolism.
