B.

Pathophysiology

a) Schematic Diagram (book – based)

Non – modifiable Risk Factors: Modifiable Risk Factors:

-45 y/o and above -Glucokinase mutation -Obesity -Sedentary lifestyle
-African American, Native -Familial history of DM type 2 -Stress -gestational DM
Americans, Asian American -Familial history of hypertension -Previously known Impaired - certain medication such as
Pacific Islander Fasting glucose Thiazides & corticosteroids.
-↑consumption of fatty, salty - Smoking
& sweet food - Alcoholism

Insulin resistance and desensitization

↓insulin production ↑glucagon Fats and Proteins breaks

Release down to glucose

↑blood Impaired glucose Cellular

absorption starvation Wasting
glucose level

Weight loss / fatigue

↑osmolality Polyphagia

Chronic glucose
Fluid shifts from elevation Glycoprotein cell
IC to IV wall deposits

Sluggish blood
Cellular dehydration ↑blood volume
flow Narrowing of
blood vessel
Thirst activation ↑GFR

polydipsia polyuria
 Small vessel Accelerated
disease atherosclerosis ↑LDL

Hypertension Coronary Artery Disease

Diabetic Diabetic
retinopathy neuropathy
Plaque rupture

Alteration numbness
in vision/ Exposure of subendohelial matrix
blindness
Foot
ulceration
Platelet activation

Diabetic Change in platelet Platelet ↑ Expression of Platelet

nephropathy shape degranulation GP IIb/IIIa

ESRD Platelet adhesion to Release of Thromboxane A2, Enhanced affinity to

subendothelial matrix Serotonin and other platelet fibrinogen
aggregatory agent

Platelet aggregation

↓ Arterial lumen Plasma Coagulation

System activation

Formation of thrombin

Converts fibrinogen Enhances platelet

to fibrin aggregation

Stabilization of
Nidusfibrin clot
of rethrombosis
Backflow of
Impaired
blood in the
Productive Pulmonary repolarization of the Blood pooling
of on left ↓
Adventitious lungs
myocardium
Release lysosomal
Re-establishment ofventricular
Hardening theofendothelium
the Irregular heart
Myocardial
cough
Breath sounds congestion enzymes
ventricle function ↓cardiac contractility ↑BP, HR, and O needs irritability
beats
Fatigue ↓ oxygenation
DOB Lactic
Anaerobic
ECG changes
acid production
glycolysis
Angina ↑ CKMB
Ischemia
with fibrotic coronary
Vasospasm
Impaired
ofMyocardial
the
Coronary
tissue arteries
dislodges
cardiac
tissue ↓ cell
supplied
occlusion
andCOperfusion
death
thrombus
by the artery
thrombus SNS
vasocontriction
Stimulation
2