During his routine physical a 46 year-old overweight male is informed that his b
ID: 3473502 • Letter: D
Question
During his routine physical a 46 year-old overweight male is informed that his blood glucose levels arc elevated. Paul is told that he has diabetes mellitus and instructed to begin a diet and exercise routine. a) What is the difference between Type I and Type II diabetes? b) What is the typical treatment for each? c) What are the three cardinal symptoms of diabetes mellitus? d) What causes ketoacidosis? Roger Proulx has severe arthritis and has been taking prednisone (glucocorticoid) for eight months. He isn't feeling well, complains of repeated "colds, " and is extremely "puffy" (edematous). a) Why was Roger put on prednisone? b) Prednisone is a synthetic glucocorticoid. Why is Cortisol essential to life? What are the effects of excessive Cortisol? c) Explain the reason for each of Roger's symptoms. Scan, a 42 year-old single father, goes to his physician complaining of nausea and chronic fatigue. He reports having felt fatigued and listless for about six months but he had attributed it to stress. He has lost considerable weight and strangely, his skin has a healthy tan even though he spends long hours at work and rarely ventures outside. His doctor finds very low blood pressure and a rapid, weak pulse. Blood tests show that Sean does not have anemia but his plasma glucose, Cortisol, and Na+ are low whereas his plasma K+ is high. His doctor orders an ACTH stimulation test to measure his secretion of Cortisol after being given a synthetic form of ACTH. a) What would account for Sean's low plasma Na+ and high plasma K+? b) What is the reason for doing an ACTH stimulation test? c) What gland is primarily affected if ACTH does not cause a normal elevation of Cortisol secretion? d) What is this abnormality called? e) What gland is primarily affected if ACTH does cause an elevation of Cortisol secretion?Explanation / Answer
Answer:
a) Type 1 diabetes is insulin-dependent diabetes. In type 1 diabetes, the body's immune system destroys the cells that release insulin, eventually eliminating insulin production from the body. Cells cannot absorb sugar (glucose) without insulin, which they need to produce energy.
Type 2 diabetes is non-insulin-dependent diabetes. Type 2 diabetes is called insulin resistance because the body loses its ability to use insulin the right way. It causes the pancreas to make less insulin which leads to insulin deficiency.
b) Type 1 diabetes is treated with insulin injections or insulin pump. Type 2 diabetes is treated initially without medication or with tablets. Its first line treatment includes diet, weight control and physical activity.
c) Cardinal symptoms of Diabetes Mellitus are: Polyuria (frequent urination), Polydipsia (increased thirst) and Polyphagia (increased hunger).
d) Ketoacidosis is caused by deficiency in the insulin quantity. Cells cannot absorb sugar (glucose) without insulin, which they need to produce energy. The lack of insulin prevents glucose absorption; in response the body switches to burning fatty acids which produces acidic ketone bodies. Ketones thus produced will enter the bloodstream. It makes blood too acidic which can change the normal functioning of internal organs and causes chemical imbalance. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.
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