Endocrine

Question 1

Where is insulin produced?

Answer 1

By beta cells in the Islets of Langerhans / pancreatic islets (pancreas)

Question 2

What is the function of insulin?

Answer 2

Lowers blood glucose by allowing uptake into insulin-dependent cells (muscle & fat); promotes glycogen, protein & fat synthesis; inhibits liver glucose release.

Question 3

How does insulin help glucose enter cells?

Answer 3

Insulin binds to receptors → GLUT-4 transporters move to surface → glucose enters the cell for energy.

Question 4

Where is glucagon produced?

Answer 4

By alpha cells in the pancreas

Question 5

What is the function of glucagon?

Answer 5

Raises blood glucose by stimulating glycogen breakdown and glucose release from the liver.

Question 6

What is diabetes mellitus?

Answer 6

A chronic condition where the body cannot properly regulate blood glucose due to insulin deficiency or resistance.

Question 7

What causes Type 1 Diabetes Mellitus (T1DM)?

Answer 7

Autoimmune destruction of beta cells leading to no insulin production.

Question 8

What are key features of Type 1 Diabetes?

Answer 8

Sudden onset, usually in young people, insulin-dependent.

Question 9

What causes Type 2 Diabetes Mellitus (T2DM)?

Answer 9

Insulin resistance and reduced insulin secretion.

Question 10

What are key features of Type 2 Diabetes?

Answer 10

Gradual onset, associated with obesity and lifestyle factors.

Question 11

What is gestational diabetes?

Answer 11

Glucose intolerance during pregnancy; increases risk of developing Type 2 Diabetes later.

Question 12

What are risk factors for Type 2 Diabetes?

Answer 12

Overweight/obesity, sedentary lifestyle, age >35, family history, ATSI/Pacific Islander/Indian/Asian background, history of gestational diabetes.

Question 13

What are the 3 main symptoms of diabetes?

Answer 13

Polyuria (frequent urination), Polydipsia (excessive thirst), Polyphagia (excessive hunger).

Question 14

Other signs and symptoms of diabetes?

Answer 14

Fatigue, weight changes, blurred vision, slow wound healing.

Question 15

How is Type 1 Diabetes managed?

Answer 15

Lifelong insulin therapy, rotating injection sites, and regular blood glucose monitoring.

Question 16

How is Type 2 Diabetes managed?

Answer 16

Lifestyle changes (diet, exercise, weight control), oral medications (Metformin, Sulphonylureas), and insulin if not controlled.

Question 17

What is the mechanism of Metformin?

Answer 17

Decreases liver glucose production and increases insulin sensitivity.

Question 18

What is the mechanism of Sulphonylureas?

Answer 18

Stimulates insulin release from the pancreas.

Question 19

What holistic care is important for diabetes?

Answer 19

Education, regular check-ups, and self-monitoring of blood glucose.

Question 20

What is hypoglycaemia?

Answer 20

Blood glucose level below 4 mmol/L.

Question 21

What causes hypoglycaemia?

Answer 21

Too much insulin or OHA, not eating, excess exercise, or alcohol.

Question 22

What are symptoms of hypoglycaemia?

Answer 22

Sweating, shaking, hunger, headache → confusion, seizures, coma.

Question 23

How is mild hypoglycaemia treated?

Answer 23

15–20g fast-acting carbs → recheck BGL → follow with slow-acting carbs.

Question 24

How is severe hypoglycaemia treated?

Answer 24

IV dextrose or IM glucagon.

Question 25

What is hyperglycaemia?

Answer 25

High blood glucose due to missed insulin/OHA, illness, or stress.

Question 26

What are symptoms of hyperglycaemia?

Answer 26

3 Ps, fatigue, blurred vision; can progress to DKA (T1DM) or HHS (T2DM).

Question 27

What is diabetic ketoacidosis (DKA)?

Answer 27

A Type 1 emergency caused by lack of insulin → fat breakdown → ketones → metabolic acidosis.

Question 28

What are signs of DKA?

Answer 28

Kussmaul breathing, fruity breath, dehydration, nausea/vomiting, confusion.

Question 29

What are key lab findings in DKA?

Answer 29

BGL >11 mmol/L, positive ketones, pH <7.3.

Question 30

How is DKA treated?

Answer 30

IV fluids, insulin infusion, potassium correction, monitor ABGs.

Question 31

What is Hyperosmolar Hyperglycaemic State (HHS)?

Answer 31

A Type 2 emergency caused by severe hyperglycaemia without ketones.

Question 32

What are signs of HHS?

Answer 32

Dehydration, altered LOC, seizures, hypotension.

Question 33

What are key lab findings in HHS?

Answer 33

BGL >30 mmol/L, no ketones, pH >7.3.

Question 34

How is HHS treated?

Answer 34

Slow IV fluids, insulin, electrolyte correction.

Question 35

What are chronic complications of diabetes?

Answer 35

Cardiovascular disease, kidney failure, neuropathy, retinopathy, poor wound healing, infections.

Question 36

What causes long-term complications in diabetes?

Answer 36

Poorly controlled diabetes leading to persistent hyperglycaemia, causing irreversible cell damage and AGE (Advanced Glycation End-products) buildup.

Question 37

What are the main categories of long-term diabetes complications?

Answer 37

Microvascular, macrovascular, and infection-related complications.

Question 38

What are microvascular complications of diabetes?

Answer 38

Diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy.

Question 39

What is diabetic retinopathy?

Answer 39

Damage to retinal blood vessels due to high BGL and AGE buildup causing vessel thickening, leakage, and microaneurysms.

Question 40

What causes vision loss in diabetic retinopathy?

Answer 40

Macular oedema, haemorrhages, and neovascularisation leading to bleeding, scarring, and blindness.

Question 41

What factor worsens diabetic retinopathy?

Answer 41

Hypertension.

Question 42

What is diabetic neuropathy?

Answer 42

Nerve damage from high BGL causing sorbitol and AGE accumulation, leading to ischaemia and demyelination.

Question 43

What mechanisms contribute to diabetic neuropathy?

Answer 43

Reduced blood flow and nitric oxide → impaired nerve conduction.

Question 44

What are the types of diabetic neuropathy?

Answer 44

Peripheral (numbness, tingling, burning pain in hands/feet) and autonomic (tachycardia, orthostatic hypotension, gastroparesis, bladder & sexual dysfunction).

Question 45

What are risks associated with diabetic neuropathy?

Answer 45

Foot ulcers, infections, and amputations.

Question 46

What is diabetic nephropathy?

Answer 46

Kidney damage caused by high glucose leading to glomerular capillary thickening and nephron loss.

Question 47

How does diabetic nephropathy affect kidney function?

Answer 47

Causes protein (albumin) to leak into urine and reduces GFR, potentially progressing to chronic kidney disease.

Question 48

What are macrovascular complications of diabetes?

Answer 48

Atherosclerosis and cardiovascular disease.

Question 49

How does diabetes contribute to atherosclerosis?

Answer 49

AGEs and lipid oxidation cause endothelial injury and plaque formation.

Question 50

What cardiovascular diseases are common in diabetes?

Answer 50

Coronary artery disease (angina, MI), cerebrovascular disease (stroke, TIA), and peripheral vascular disease (ulcers, gangrene).

Question 51

How much higher is cardiovascular risk in people with diabetes?

Answer 51

2–4 times higher.

Question 52

Why are people with diabetes more prone to infections?

Answer 52

High glucose impairs neutrophil and macrophage function, reducing immune response.

Question 53

How does poor circulation affect infection risk in diabetes?

Answer 53

Decreased blood flow and oxygen lead to poor wound healing.

Question 54

What are common infections in people with diabetes?

Answer 54

Skin, urinary tract, foot ulcers, dental, and respiratory infections.

Question 55

Why are unnoticed injuries more common in diabetics?

Answer 55

Vision loss and neuropathy reduce pain and injury awareness.

Question 56

What are key long-term monitoring checks for diabetes?

Answer 56

HbA1c – assess long-term glucose control Retinal screening – detect early eye changes Foot checks – sensation & ulcer risk Urine ACR & GFR – kidney function BP & lipid profile – reduce CVD risk Dental & mental health – regular assessments