Endocrine: type 1 diabetes mellitus: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Endocrine: type 1 diabetes mellitus

Sample item

A 12-year-old girl presents in diabetic ketoacidosis a few weeks after a viral illness. If a pancreatic biopsy had been taken early in the disease, what would it have shown?

AAmyloid deposition within the isletsBHyperplastic islets with increased beta cell massCLymphocytic infiltration of islets with loss of beta cellsDPancreatic fibrosis with ductal calcification

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Lymphocytic infiltration of islets with loss of beta cells

Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells, mediated by CD8 and CD4 T lymphocytes, with associations with HLA-DR3 and DR4 and autoantibodies against GAD65, insulin and islet antigens. Insulitis is seen early, and later the islets are atrophic with few beta cells. Clinical disease appears after about 80 to 90 percent of beta cell mass is lost.

Option by option

A. Amyloid deposition within the islets
Islet amyloid derived from amylin is found in type 2 diabetes.
B. Hyperplastic islets with increased beta cell mass
Islet hyperplasia is seen in infants of diabetic mothers owing to fetal hyperinsulinism.
C. Lymphocytic infiltration of islets with loss of beta cells (correct)
Correct. Insulitis with beta cell depletion characterises type 1 diabetes.
D. Pancreatic fibrosis with ductal calcification
Fibrosis and calcification are features of chronic pancreatitis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Lymphocytic infiltration of islets with loss of beta cells. Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells, mediated by CD8 and CD4 T lymphocytes, with associations with HLA-DR3 and DR4 and autoantibodies against GAD65, insulin and islet antigens.

Why is "Amyloid deposition within the islets" not the answer?

Islet amyloid derived from amylin is found in type 2 diabetes.

Why is "Hyperplastic islets with increased beta cell mass" not the answer?

Islet hyperplasia is seen in infants of diabetic mothers owing to fetal hyperinsulinism.

Why is "Pancreatic fibrosis with ductal calcification" not the answer?

Fibrosis and calcification are features of chronic pancreatitis.

What concept does this question test?

It tests Endocrine: type 1 diabetes mellitus in Pathology. Insulitis is seen early, and later the islets are atrophic with few beta cells. Clinical disease appears after about 80 to 90 percent of beta cell mass is lost.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrine: type 1 diabetes mellitus?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.