Diabetes Flashcards

1
Q

Type 1 diabetes is also known as ………

A

IDDM (Insulin dependent)

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2
Q

Type 2 diabetes is also known as ………

A

NIDDM (Non-insulin dependent)

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3
Q

What pharmacological treatments are available for Type 2 diabetes?

A

Biguanides
Sulfonylureas

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4
Q

What is a example of a biguanide and what effect does it have?

A

Metformin
Stops glucose production

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5
Q

What is a example of a sulfonylureas and what effect does it have?

A

Gliclazide
Stimulates insulin production

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6
Q

What ocular complications can happen as a result of diabetes?

A

Cataracts
Corneal opacities
Diabetic retinopathy
Refractive changes
Open-angle glaucoma
Tritanopia defect
CN palsies
Recurrent infections

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7
Q

What are the risk factors for diabetic retinopathy?

A

Length of diabetes
Quality of metabolic control
Smoking
Obesity
Hypertension
Hyperglycaemia
Pregnancy
Renal disease
Anaemia
Cataract surgery

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8
Q

What are the biochemical pathways that contribute to the development of DR?

A

Polyol pathway
Increased expression of growth factors
Oxidative stress
Inflammation
Genetic factors

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9
Q

What is the polyol pathway?

A

Sorbitol accumulation due to increased glucose levels (glucose is turned to sorbitol by enzymes)

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10
Q

What type of complication of diabetes is DR?

A

Microvascular

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11
Q

Why does the increased expression of growth factors contribute to the development of DR?

A

Neovascularisation is promoted, so vascular permeability increases (due to more blood vessels existing)

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12
Q

What are the stages of DR?

A

Non-proliferative (mild, moderate and severe)
Proliferative
Diabetic maculopathy

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13
Q

What are the signs of Mild NP DR?

A

At least one microaneurysm by itself or with:
Dot/blot haem
Hard exudates
CWS
Venous loops

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14
Q

What are the signs of moderate NP DR?

A

As mild plus:
Increased no of microaneurysms and haem
Larger haem (deeper)
CWS
Venous beading

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15
Q

What are the signs of severe NP DR?

A

4 quadrants: haem or microaneurysms
2 quadrants: venous beading
1 quadrant: Intraretinal microvascular abnormalities (IRMA)

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16
Q

Which layers of the retina do dot/blot haem occur in?

A

Nuclear and plexiform layers

17
Q

Which layer of the retina do hard exudates occur in?

A

Outer plexiform layer

18
Q

Which layers of the retina do microaneurysms occur in?

A

Nuclear layers

19
Q

Which layer of the retina do CWS occur in?

A

NFL

20
Q

What is intraretinal microvascular abnormalities (IRMA)?

A

Clusters of microaneurysms and tortuous vessels

21
Q

What are the signs of Proliferative DR?

A

Neovascularisation
Vitreous detachment
Preretinal or vitreous haem
Retinal detachment

22
Q

What are the signs of diabetic maculopathy?

A

Foveal oedema (vascular leakage) - loss of foveal pit
Central vision loss

23
Q

What is the treatment for DR?

A

Manage blood sugars
Laser treatment to stop further progression
Vitrectomy
Intravitreal injections (corticosteroids or VEGF inhibitors)