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Endocrine SOH > Complications of diabetes > Flashcards

Complications of diabetes Flashcards

1
Q

Emergency complications (3)

A

DKA - diabetic ketoacidosis
HHS - hyperglycaemic hypersmolar syndrome
Lactic acidosis

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2
Q

DKA - definition

A

When insulin is not injected, cells fail to receive enough glucose and they switch to fat breakdown instead.
This results in the accumulation of ketones due to increased tissue fatty acid metabolism and increased blood glucose levels

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3
Q

DKA - cause

A

Infection
Newly diagnosed diabetes
Non adherence with insulin
Alcohol

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4
Q

DKA - which type of diabetics most commonly get it?

A

Type 1 diabetics

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5
Q

DKA - classic history

A

2 day Hx of nausea after a party where the patient consumed lots of alcohol.
Pt is now not eating and therefore decided to reduce his insulin intake

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6
Q

DKA - clinical features

A 
Vomiting 
Abdominal pain
Kussmal breathing 
Pear drop smelling breath 
Drowsiness
Thirst
Polyuria
Dehydration
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7
Q

DKA - investigations

A

Urinalysis: ++ketones, ++glucose
ABG: metabolic acidosis
Increased K+
Increased creatinine

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8
Q

DKA - management

A

Replace fluid loss - NaCl
IV insulin
Prophylactic LMWH

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9
Q

HHS - definition

A

Hypovolaemia + hyperglycaemia + hypersmolar (increased osmolality)

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10
Q

HHS - cause

A

Steroids
Thiazides
Sepsis

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11
Q

HHS - which type of diabetics most commonly get it ?

A

Type 2 diabetics

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12
Q

HHS - clinical features

A 
Nausea 
Thirst 
Polyuria 
Dry skin 
Drowsiness
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13
Q

HHS - investigations

A

Urinalysis: + glucose, no ketones

Significant increase in osmolality (i.e. significant dehydration)

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14
Q

HHS - management

A

Fluids
Insulin - in some patients
Sodium
LMWH

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15
Q

Lactic acidosis - definition

A

Build up of lactate in the body due to anaerobic metabolism of glucose
It causes metabolic acidosis

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16
Q

Lactic acidosis - clinical features

A

Hyperventilation

Mental confusion

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17
Q

Lactic acidosis - investigations

A

Measure lactate level

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18
Q

What is the normal lactate level?

A

O.6-1.2

19
Q

Lactic acidosis - management

A

Treat the underlying condition with fluids and antibiotics

20
Q

Alcohol induced ketoacidosis - definition

A

Metabolic complication of alcohol use and starvation

21
Q

Alcohol induced ketoacidosis - clinical features

A

Recurrent vomiting
Abdominal pain
Difficult to rouse

22
Q

Alcohol induced ketoacidosis - investigations

A

Increased ketones
Increased lactate
Decreased bicarbonate

23
Q

Alcohol induced ketoacidosis - management

A

High dose vitamins

IV fluids

24
Q

Microvascular complications of diabetes - risk factors

A 
Increased duration of diabetes
Poor glycemic control 
Smoking
Alcohol
Mechanical injury
25
Q

Microvascular complications of diabetes - which type of diabetics are most likely to get this?

A

Type 1

26
Q

Microvascular complications of diabetes (4)

A

Feet problems
Neuropathy
Nephropathy
Retinopathy

27
Q

Peripheral neuropathy - definition

A

Develops when the body’s extremities are damaged

28
Q

Peripheral neuropathy - clinical features

A 
Numbness
Loss of sensation 
Tingling and burning (paraesthesia) 
Sharp pain
Loss of balance
29
Q

Peripheral neuropathy - management

A

If localised: capsaicin cream

If generalised: amitryptiline, gabapentin

30
Q

Peripheral neuropathy - complications

A

Charcot’s foot

Foot ulcer

31
Q

Autonomic neuropathy - definition

A

Affects nerves regulating the heart rate and blood pressure

32
Q

Autonomic neuropathy - clinical features

A

Changes in bowel habit, gastroparesis, change in heart rate and blood pressure

33
Q

FOcal neuropathy - definition

A

Affects a single nerve (mainly in wrist, thigh, foot)

34
Q

Diabetic foot ulcer pathogenesis

A

When NS is damaged, there is no sweating in the feet
Feet become dry and cracked
Infection can enter through the cracks

35
Q

Charcot’s foot - pathogenesis

A

Injury to the numb foot results in gross abnormality as the patient has no awareness to the foot damage

36
Q

Nephropathy - definition

A

Caused by damage to the capillaries in the kidney’s glomeruli

37
Q

Nephropathy - commonly affected areas

A

Peripheries

- hands and feet

38
Q

Nephropathy - clinical features

A

Discomfort in the lower legs
Rapid weight loss
Loss of sensation in the extremities of the limbs

39
Q

Nephropathy - investigations

A

Urinary albumin creatinine ratio

40
Q

Nephropathy - management

A

ACE inhibitor

ARB

41
Q

Retinopathy - definition

A

Disease of the retina which results in impaired vision or loss of vision

42
Q

Retinopathy - eye features

A

Blot haemorrhages
Hard exudates
Cotton wool spots
Changes around the macula

43
Q

Retinopathy - management

A

Laser
Vitrectomy
Anti VEGF injections

Endocrine SOH (25 decks)

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