amputation/diabetes

Question 1

what are some causes of peripheral vascular disease?

Answer 1

• diabetes
• hypertension
• hyperlipidemia
• smoking

Question 2

what is PVD?

Answer 2

narrowing of blood vessels outside heart

Question 3

what is PVD most likely due to?

Answer 3

atherosclerosis

Question 4

what areas of the skin can be assessed for PVD?

Answer 4

• touch
• hair growth
• nails
• appearance
• pulse

Question 5

what areas can be assessed for ulcers and PVD?

Answer 5

• pain
• colour
• edges
• location

Question 6

how can pain be assessed for PVD?

Answer 6

type and activity

Question 7

what are some treatments for PVD?

Answer 7

• lifestyle change
• treatment of existing conditions
• medication
• angioplasty
• vascular surgery
• if re-vascularisation is not possible > amputation

Question 8

what may the surgeon take into account deciding the level of amputation?

Answer 8

• adequate vascularisation

- ability to create stump for prosthetic

Question 9

what are some causes of upper extremity amputation?

Answer 9

• severe trauma
• PVD
• thermal burns/frost bite

Question 10

what is hyperglycemia?

Answer 10

high blood glucose level, inability of cells to take in glucose from blood

Question 11

what does insulin do?

Answer 11

allows transport of glucose into cells, lowers blood glucose levels

Question 12

how is insulin synthesised?

Answer 12

B cells of islets of Langerhans in pancreas

Question 13

what synthesises glucagon?

Answer 13

a cells in pancreas

Question 14

what does increased blood glucose levels trigger B cells to release?

Answer 14

insulin

Question 15

how long is the 1st phase of glucose 2 uptake?

Answer 15

within 2mins, lasts 10-15mins

Question 16

how long does the 2nd phase of glucose uptake last?

Answer 16

until blood glucose levels are back to normal

Question 17

what is glycogenesis?

Answer 17

excess glucose converted to glycogen

Question 18

what is gluconeogenesis?

Answer 18

production of glucose by liver

Question 19

what is glycolysis?

Answer 19

glucose transported into muscle cells for ATP production

Question 20

what occurs for the pathogenesis of type 1 diabetes in the liver?

Answer 20

-increases breakdown of stored glucose and production of glucose from non-carb sources

Question 21

what occurs for the pathogenesis of type 1 diabetes in the muscle?

Answer 21

decreased glucose uptake due to absence of insulin and glycogenesis

Question 22

what occurs for the pathogenesis of type 1 diabetes in the adipose?

Answer 22

increased breakdown of aft (lipolysis) and production of free fatty acids (ketoacidosis)

Question 23

what occurs for the pathogenesis of type 1 diabetes in the protein?

Answer 23

• decreased acid production and protein synthesis

- increased protein breakdown

Question 24

how does type 2 diabetes result in insulin resistance?

Answer 24

• loss of insulin post-receptor signalling

- down regulation of insulin receptors

Question 25

what does obesity inhibit insulin signaling?

Answer 25

free fatty aicds and cytokines from fat cells

Question 26

what occurs when there is insulin deficiency in type 2 diabetes?

Answer 26

- b cell dysfunction | - inadequate insulin secretion and glucose uptake

Question 27

what does type 1 diabetes occur as a result of?

Answer 27

-insulin not secreted from pancreas due to destruction of B cells

Question 28

what does type 2 diabetes occur as a result of?

Answer 28

- insulin deficiency/resistance | - b cell dysfunction/stress

Question 29

what are some treatment options for type 2 diabetes?

Answer 29

- diet/exercise | - oral and hypoglyaemic agents

Question 30

what are some consequences of chronic uncontrolled hyperglycemia?

Answer 30

vascular complications and neurpathies

Question 31

what can occur with feet and PVD/diabetic neuropathy?

Answer 31

- loss of sensation - impaired wound healing - infection/gangrene

Question 32

what are some causes of diabetic foot ulcers?

Answer 32

- peripheral neuropathy - deformity - callus - shoes - trauma - pressure