Case 8 - 56 yo M for DM follow-up Flashcards
1
Q
Information gathering
A
CC Onset Treatment Compliance Last blood sugar reading Blood sugar monitoring Last HbA1c Last time eyes were checked How he is feeling today? Medication side effects Heart symptoms (chest pain, palpitations) Description of symptoms Pulmonary complaints (SOB, cough) Neurologic complaints (HAs, dizziness, weakness and numbness) Polyuria, dysuria, hematuria Abdominal complaints (pain, dyspepsia, nausea) Change in bowel habits Blurred vision Foot infections Marital or work problems, anxiety and stress Weight changes, appetite changes HTN, HLD Prior heart problems, TIA, stroke Current medications PMHx PSHx FHx Social Hx (occupation, diet, exercise, tobacco, alcohol and drug use, sexual activity) CAGE questions Type of sexual problem, libido, duration, depression Drug allergies
2
Q
Physical examination
A
Eye exam (fundoscopic exam)
Neck exam (carotid auscultation)
CV exam
Pulmonary exam
Abdominal exam
Extremities (inspect feet and peripheral pulses)
Neurologic exam (DTRs, Babinski’s sign, sensation and strength in lower extremities)
3
Q
Closure
A
Lifestyle modification
Examination of your genital area
4
Q
Differential diagnosis
A
Insulin-induced hypoglycemia
Diabetic peripheral neuropathy
Organic erectile dysfunction
5
Q
Diagnostic work-up
A
Genital exam (R/O Peyronie's disease) Serum glucose, HbA1c UA, urine microalbumin, BUN/Cr Doppler US - penis Nerve conduction studies CBC, serum calcium, ESR, serum protein electrophoresis
