Diabetes

Question 1

Long term complication of DM (8)

Answer 1

*angiopathy
*nephropathy
*neuropathy
*Skin issues
*infections
*psychological issues
*retinopathy
*glaucoma

Question 2

neuropathy: what

Answer 2

*what: nerve damage that happens bc of the metabolic imbalances associated with

Question 3

neuropathy: types

Answer 3

*types: sensory neuropathy (most common and affects the the peripheral nervous system) and autonomic (can affect nearly all the body systems)

Question 4

neuropathy: complications

Answer 4

*complications: lead to ulcers -> amputations, ED, gastroparesis, painless MI

Question 5

neuropathy: tx

Answer 5

*tx: screen promptly at time of DM diagnosis, drug therapy, neurogenic bladder

Question 6

PAD: what

Answer 6

*what: increases risk for amputation by causing reduced blood flow to the lower extremities -> decreased o2, WBC, and nutrients to tissue -> delayed wound healing -> increased risk for infection

Question 7

PAD: educate (5)

Answer 7

*educate: prevent foot ulcers (proper footwear, avoid foot injury, practice diligent foot/nail care, inspect foot each day, treat small problems promptly)

Question 7

PAD: s/s (6)

Answer 7

*s/s: intermittent claudication, pain at rest, cold feet, loss of hair, delayed cap refill, and dependent rubor (redness in skin when extremity is in dependent position.

Question 7

PAD: management (3)

Answer 7

*management: reduce rf (smoking, cholesterol intake, htn), bypass or graft surgery

Question 7

PAD: dx (3)

Answer 7

*DX: hx, ankle-brachial index, and angiography

Question 8

retinopathy: examination

Answer 8

funduscopic: dilated eye examination done anually

Question 9

retinopathy: types

Answer 9

*nonproliferative: early stage of diabetic eye disease where small blood vessels in the retina weaken and leak fluid or blood, potentially causing blurry vision or even vision loss over time if left untreated

*Proliferative (more severe): a serious eye condition where new, abnormal blood vessels grow in the retina, which can lead to vision loss if not treated. (if macula involved = vision lossed)

Question 10

low GFR

Answer 10

*nephropathy: hyperglycemia and HTN-> damaged small blood vessels of the kidneys (glomeruli) -> inability to filter wast products -> decreased GFR over time

Question 11

what is diabetes

Answer 11

a chronic multisystem disease characterized by hyperglycemia from abnormal insulin production, impaired insulin use, or both

Question 12

T1DM: patho/cause

Answer 12

*body develops antibodies against insulin or pancreatic beta cells that make insulin
*genetic predisposition and/or exposure to a virus may contribute to development of T1DM
*body is not able to produce enough insulin to sustain life requiring outside source

Question 13

symptoms of preDM (6)

Answer 13

fatigue
frequent infection
slow wound healing
polyuria
polydipsia
polyphagia

Question 14

major distinction between DM 1 and 2

Answer 14

endogenous insulin (absent in DM1)

Question 15

which organs have altered mechanisms in 1 and 2

Answer 15

1: pancreas
2: pancreas, liver, adipose tissue, muscles

Question 16

Dx for DM

Answer 16

*A1C of 6.5% or more (Prediabetic: 5.7-6.4%)
*fasting plasma glucose: 126 or more
*2-hour plasma glucose of 200 or more

Question 17

4 types of insulin

Answer 17

rapid
short
intermediate
long

Question 18

PAD: foot ulcer tx (7)

Answer 18

*foot ulcer tx: casting, wound care (debridement, dressing, advanced wound healing products, vacuum-assisted closure, ultrasound, hyperbaric o2, skin grafting)

Question 19

micro vs macrovascular complications

Answer 19

*micr: small vessels (eyes: retinopathy, kidneys: nephropathy, nerves: neuropathy(

*Macro: medium to large vessels (cardio, cerebro, peripheral vascular)