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Endocrinology > Complications of Diabetes > Flashcards

Complications of Diabetes Flashcards

1
Q

what are the 4 types of neuropathy?

A
  • peripheral
  • autonomic
  • proximal
  • focal
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2
Q

peripheral neuropathy examples

A

pain/loss of feeling in feet or hands

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3
Q

autonomic neuropathy examples

A

changes in bowel/bladder function, sexual response, sweating, HR, BP, hypoglycaemic unawareness

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4
Q

proximal neuropathy examples

A

pain in the thighs, hips or buttocks leading to weakness in the legs

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5
Q

focal neuropathy examples

A

sudden weakness in one nerve or a group of nerves causing muscle weakness or pain

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6
Q

give some examples of nerves affected/syndromes caused by focal neuropathy

A 
carpal tunnel 
ulnar mono neuropathy 
foot drop 
bells palsy 
cranial nerve palsy
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7
Q

what complications of peripheral nerve damage can occur?

A

infections/ulcers
deformities
amputations

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8
Q

what is rocker bottom foot?

A

bony destruction in secondary to neuropathy, prominent area at bottom of foot, very susceptible to ulceration

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9
Q

what is the treatment algorithm of painful neuropathy?

A 
simple analgesia 
TCAs
Gabapentin 
Duloxetine 
stronger opiods
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10
Q

what are the 3 possible outcomes of autonomic neuropathy in the digestive systme?

A
  • gastric slowing/frequency change
  • gastroparesis
  • oesophagus nerve damage
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11
Q

what symptoms would you see in gastric slowing/frequency change?

A

constipation/diarrhoea

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12
Q

what symptoms would you see in gastroparesis?

A

persistent nausea & vomiting
bloating
loss of appetite

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13
Q

what is gastroparesis?

A

slow stomach emptying

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14
Q

what can gastroparesis do to blood glucose levels & how?

A

fluctuate widely due to abnormal food digestion

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15
Q

what can oesophagus nerve damage cause?

A

may make swallowing difficult & can lead to weight loss

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16
Q

what is the treatment of gastroparesis?

A

Consider a trial of metoclopramide, domperidone, or erythromycin
gastric pacemaker

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17
Q

what are the possible outcomes of autonomic neuropathy affecting the sweat glands?

A

prevents sweat glands from working properly:

  • profuse sweating at night
  • profuse sweating while eating
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18
Q

gustatory sweating

A

profuse sweating while/after you eat

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19
Q

what can happen in hypoglycaemia in autonomic neuropathy?

A

hypoglycaemic unawareness

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20
Q

what happens to the body if the CVS nerves are damaged?

A

interferes with the body’s ability to adjust blood pressure & heart rate

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21
Q

what happens to blood pressure if the CVS nerves are damaged?

A

may drop sharply after sitting or standing

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22
Q

what does a person feel if their blood pressure drops sharply?

A

feels light-headed/faint

23
Q

what happens to heart rate if the CVS nerves are damaged?

A

may stay high instead of going high or low in response to activity

24
Q

how can autonomic neuropathy affect the eyes?

A

can affect the pupils making them less responsive to changes in light

25
Q

name 4 diagnostic tools for neuropathy

A
  • nerve conduction studies or electromyography
  • heart rate variability
  • ultrasound
  • gastric emptying studies
26
Q

amyotrophy

A

asymmetrical proximal motor neuropathy

27
Q

wha is diabetic nephropathy also known as?

A

kimmelsteil-Wilson Syndrome

nodular glomerulosclerosis

28
Q

what are the consequences of diabetic nephropathy?

A
  • development of hypertension
  • relentless decline in renal function
  • accelerated vascular disease
29
Q

who should be screened for nephropathy?

A

diabetics aged 12+

at diagnosis & annually

30
Q

how can you screen for diabetic kidney disease?

A

use urinary albumin creatinine ratio

31
Q

what is the normal range for the albumin:creatinine ratio in males?

A
32
Q

what is the normal range for the albumin:creatinine ratio in females?

A
33
Q

what is the range that signifies microalbuminuria?

A

30-300 mg/ml

34
Q

what is the range that signifies macroalbuminuria?

A

> 300 mg/ml

35
Q

what are the risk factors for nephropathy progression?

A 
hypertension 
cholesterol 
smoking 
glycaemic control 
abluminuria
36
Q

diabetic patients with microalbuminuria/proteinuria should be offered which class of drugs?

A

ACE inhibitor

37
Q

what should a diabetics blood pressure be maintained at?

A
38
Q

what happens in diabetic eye disease?

A
  • diabetic retinopathy
  • cataract
  • glaucoma
  • acute hyperglycaemia
39
Q

cataract

A

clouding of the lens

40
Q

glaucoma

A

increase in fluid pressure in the eye leading to optic nerve damage

41
Q

what happens in diabetic eye disease in acute hyperglycaemia?

A

reversible visual blurring

42
Q

what are the 4 stages of retinopathy?

A

Mild non-proliferative (Background)
Moderate non-proliferative
Severe non-proliferative
Proliferative

43
Q

haemorrages

A

dot/blot/flame

44
Q

cotton wool spots

A

ischaemic areas

45
Q

hard exudates

A

lipid break down products

46
Q

IRMA

A

intra-retinal microvascular abnormalities

47
Q

how would bleeding in diabetic eye disease present?

A

sudden change in vision

floaters

48
Q

what are the retinopathy treatment options?

A

laser
vitrectomy
anti-VEGF injections

49
Q

who is screened for retinopathy?

A

annula screening for all (low risk) diabetes patients

50
Q

what are the causes of erectile dysfunction in diabetes?

A

vascular

neuropathy

51
Q

which medications can cause erectile dysfunction?

A

anti-hypertensive drugs

CNS drugs

52
Q

what vascular complications does diabetes increase the risk of?

A

stroke
peripheral vascular disease
coronary artery disease

53
Q

what lifestyle changes can a diabetic undertake to reduce CVS problems?

A 
weight loss 
exercise 
smoking cessation 
improve diet 
reduce salt
54
Q

what are the psychiatric complications that can occur in diabetes?

A
  • depression
  • eating disorders
  • bi-polar
  • schizophrenia

Endocrinology (23 decks)

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