Diabetes and urinary symptoms Flashcards
What is Oliguria? Give its clinical value
Oliguria or hypouresis is the low output of urine. It is clinically classified as urine output of >80ml/day but <400ml/day
At what age do patients get diagnosed with T2DM?
How about patients with T1DM?
Middle age.
However, for T1DM, patients are usually young <25
What are the 2 most common cause of blindness?
First is age-related macular degeneration. The second most common cause is retinopathy.
What are the 3 microvascular complications of diabetes?
- Retinopathy
- Neuropathy
- Nephropathy
What is the classical presentation of diabetic neuropathy?
Symmetrical Sensory Polyneuropathy:
Loss of sensation in the “Glove and stocking” distribution
Absent ankle jerks (S1)
Besides sensory polyneuropathy, what are the 3 other presentations of diabetic neuropathy?
Cranial nerve lesions (mononeuritis multiplex), autonomic neuropathy and diabetic amyotrophy.
Name a type of laser treatment for diabetic retinopathy.
Pan-retinal photocoagulation
What are the possible side effects of Pan-retinal photocoagulation?
After the procedure, patients may experience minor headaches, where an analgesic can be taken.
It can also cause deterioration in central vision, and reduces the peripheral field vision. In severe cases, it can cause tunnel vision. It can also impair night vision.
What are the treatments of diabetic foot ulcers?
- Blood sugar control
- Removal of dead tissue from the wound
- Regular chiropody to remove callus
- Proper wound dressing
- Removing pressure from the wound through techniques such as total contact casting, bed rest and therapeutic shoes
What can be done to prevent diabetic kidney disease?
Good glycaemic and blood pressure control
What can be done for patients with diabetic kidney disease?
Can slow the progression of diabetic kidney disease by anti-hypertensive treatment such as ACE inhibitors and Angiotensin II receptor blockers.
What screenings are there for complications of diabetes?
Eye screening every year Foot examination every year Urine testing CV risk examination Blood glucose monitoring Blood pressure measurement
What is Finasteride?
Finasteride is used for the treatment of benign prostatic hyperplasia and male pattern hair loss. It is a type II and type III 5-alpha reductase inhibitor, hence inhibiting the conversion of testosterone to dihydrotestosterone.
It is sometimes used to treat pattern hair loss in men only (adrogenetic alopecia).
What is nocturia a symptom of?
Nocturia may be a symptom of renal failure (loss of urine concentrating ability) or mild cardiac failure.
What is dysuria commonly due to and what symptoms is it commonly associated with?
Dysuria is due to inflammation of the bladder, prostate or urethra.
Commonly associated with frequency and urgency.
What is the normal flow of a full bladder?
20ml/sec
What are the 3 possible causes of slow flow of urine?
Obstruction of the urethra, urethral stricture and diminished bladder contraction (weak detrusor activity) results in slow flow.
What is intermittency in urinating commonly due to?
Intermittency is usually due to prostatic obstruction with intermittent occlusion of the urethra by the lateral lobes.
How is DKA resolution determined in the clinical context?
DKA is resolved once pH is above 7.3 and serum ketone level is less than 0.3mmol/L
What is the rate of insulin infusion in DKA?
0.1 unit/kg/hour
What must be given alongside insulin treatment in DKA? Why?
Potassium infusion of 40mmol/L if K+ levels is <5.5mmol/L.
This is because insulin drives K+ into cells and this can precipitate hypokalaemia
