Nephropathy in individuals with diabetes is the leading cause of:

Choice A reason: The primary distinction between ALL and AML is the type of cell that becomes cancerous. Acute Lymphocytic Leukemia (ALL) affects the lymphoid cell line. Lymphoid cells, or lymphocytes, are a type of white blood cell that plays a crucial role in the immune system, helping the body to fight infections. There are three types of lymphocytes: B cells, T cells, and natural killer (NK) cells. In ALL, the malignant transformation of these lymphocytes occurs, leading to an overproduction of immature lymphoid cells, or lymphoblasts. These lymphoblasts crowd out normal blood cells in the bone marrow, leading to symptoms such as anemia, susceptibility to infections, and easy bruising or bleeding.

Choice B reason: While it is true that ALL is more prevalent in children and AML is more common in adults, this age distribution is not the primary distinguishing feature between the two types of leukemia. ALL represents about 75% of pediatric leukemia cases, typically affecting children between 2 and 5 years old, while AML is more commonly diagnosed in adults, with the incidence increasing with age. However, both types can occur at any age, and the age of onset alone is not sufficient to distinguish between them. The differentiation based on cell type remains the most significant factor.

Choice C reason: Clinical manifestations of ALL and AML can be very similar because both involve the proliferation of immature white blood cells in the bone marrow, which disrupts normal blood cell production. Common symptoms include fatigue, frequent infections, fever, weight loss, easy bruising or bleeding, and bone pain. These symptoms result from the overproduction of immature leukemic cells and the subsequent suppression of normal hematopoiesis. Although there may be some differences in presentation based on the specific cell types involved, clinical manifestations are not the primary basis for differentiating between ALL and AML.

Choice D reason: The diagnostic tests used for ALL and AML are quite similar and typically include complete blood counts (CBC), bone marrow biopsy, and flow cytometry to identify the types of cells involved. Cytogenetic and molecular studies are also used to detect specific genetic abnormalities associated with each type of leukemia. While certain markers and genetic mutations may differ between ALL and AML, the overall approach to diagnosis involves similar testing methods. Therefore, the primary difference between the two leukemias lies in the cell type affected rather than the specific diagnostic tests used.

Choice A reason: An enlarged pancreas is not a characteristic of type 1 diabetes. In type 1 diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas, leading to a decrease in insulin production. This does not cause the pancreas to become enlarged.

Choice B reason: Hyperglycemia and hyper ketonuria are characteristic findings in type 1 diabetes. Hyperglycemia, or high blood sugar, occurs due to the lack of insulin. Hyper ketonuria, or high levels of ketones in the urine, occurs because the body breaks down fats for energy in the absence of insulin, leading to the production of ketones.

Choice C reason: A combination of environmental and genetic factors is considered to be the cause of type 1 diabetes. Genetic predisposition and environmental triggers such as viral infections can lead to the development of the disease.

Choice D reason: Type 1 diabetes most commonly occurs in children and adolescents, with a peak occurrence between the ages of 7 and 15 years. This age range is when the majority of cases are diagnosed.