complications of diabetes

Question 1

high blood glu–>____,____,___–>activates____

Answer 1

AGE, DAG, oxidative stress–>PKC beta activation

Question 2

earliest stage of retinal involvemnet

Answer 2

non-proliferative

Question 3

microaneurysms, blot hemorrhages, cotton wool spots

Answer 3

non-proliferative diabetic retinopathy

Question 4

small vessel occlusion and retinal hypoxia, vitrous hemorrhage, retinal detachment

Answer 4

proliferative diabetic retinopathy

Question 5

best tx of reinopathy

Answer 5

prevention

Question 6

recommendations for prevention of retinopathy

Answer 6

dilated eye exam annually starting at 5 yrs post dx

Question 7

tx of macular sparing retinopathy

Answer 7

panretinal xenon/argon laser photocoagulation

Question 8

tx of macular edema

Answer 8

focal laser

Question 9

tx for retinal detachment

Answer 9

surgery

Question 10

prevention of diabetic nephropathy (3)

Answer 10

1. urine albumin annually
2. serum cr @ dx
3. nonpreggers with micro or macroalbuminemia

Question 11

medications that can be used to tx pain assc’d with diabetic neuropathy (4)

Answer 11

1. amitriptyline
2. anticonvulsants (gabapentin)
3. duloxetine
4. topical capsaicin

Question 12

severely neuropathic extremity exposed to trauma, characterized by joint dislocation, fracture, deformity - presents with swelling, incr skin temp, erythema

Answer 12

charcot arthropathy

Question 13

dyxfxn of the cholinergic, NE systems

Answer 13

autonomic neuropathies

Question 14

what sort of tests to check annually in a diabetic

Answer 14

1. eye exam
2. Cr
3. microalbumin
4. foot exam

Question 15

what is the most common cause of death in diabetics

Answer 15

ischemic heart disease

Question 16

what sort of diabetics should receive ASA as prevention?

Answer 16

T2DM men >50, women>60, with at least 1+ risk factor (FHx CVD, HTN, smoking, dyslipidemia, albuminuria

Question 17

is aggressive glycemic control more effective in microvascular or macrovascular complications?

Answer 17

microvascular;

it has NOT been shown to reduce coronary heart disease