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Y2 ENDOCRINOLOGY > Diabetes Complications > Flashcards

Diabetes Complications Flashcards

1
Q

What are the 3 main microvascular complications of diabetes?

A

Neuropathy
Nephropathy
Retinopathy

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2
Q

How does microvascular compromise generally occur in diabetes?

A

Reduced blood flow to small vessels, causing hypoperfusion of nerves in that area

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3
Q

Which parts of the body is most susceptible to diabetic neuropathy?

A

Feet and hands

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4
Q

What will peripheral neuropathy predominately cause?

A

Symmetrical pain/loss of sensation in feet/hands

Tingling, burning, sharp pain, cramps

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5
Q

Neuropathy is more common in type 2 diabetes than type 1 diabetes. True/False?

A

False

Type 1 diabetes more common

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6
Q

What are the major complications of peripheral neuropathy?

A

Infections/ulcers
Deformities (inc. Charcot foot - bone deformity due to brittle bones)
Amputations

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7
Q

Autonomic neuropathy can cause gustatory sweating. What is this?

A

Abnormal function of sweat glands, causing profuse sweating at night/during meals

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8
Q

Diabetes is the commonest cause of kidney failure. True/False?

A

True

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9
Q

What is a reliable sign of diabetic kidney failure that should be screened for?

A

Raised albumin

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10
Q

There is established microalbuminuria in diabetics if the test is repeated twice and how many are positive?

A

2/3 positive

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11
Q

List causes of false positive tests for microalbuminuria

A 
Menstruation
Pregnancy
UTI
Vaginal discharge
Non-diabetic renal disease
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12
Q

Which class of drugs is useful for diabetics with kidney failure? What other management is available?

A

ACEi/ ARBs

Dialysis in kidney failure

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13
Q

What eye pathologies do people with diabetes get?

A

Retinopathy
Cataract (clouding of lens)
Glaucoma (increased fluid pressure –> optic nerve damage)
Visual blurring (acute hyperglycaemia)

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14
Q

What is the main sign of background retinopathy (R1)?

A

Leaky blood vessels (dots)

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15
Q

What are the main signs of proliferative retinopathy (R4)?

A

Angiogenesis (due to ischaemia) - new BV formation
Haemorrhage
Leaky blood

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16
Q

What are the main signs of diabetic maculopathy (M1-M2)?

A

Build up of fluid in macula, causing exudates

Blurred/complete loss of vission

17
Q

Erectile failure occurs in about 50% of diabetic men. True/False?

A

True :(

18
Q

How does Charcot foot appear on XR?

A

‘Bag of bones’

19
Q

Outline the treatment options for peripheral neuropathy

A

Amitryptiline
Duloxetine
Anticonvulsant
Capsaicin cream

20
Q

What is focal neuropathy? Give some examples

A

Sudden weakness in specific nerves leading to muscle weakness and pain
Carpal tunnel syndrome, ulnar mononeuropathy, foot drop, bell’s palsy, CN palsy (particularly eye symptoms- double vision, eye ache)

21
Q

What are the signs of proximal neuropathy or diabetic amyotrophy?

A

Pain in thighs, hips, buttocks leading to weakness in legs, typically on one side of the body

22
Q

What are the clinical features of autonomic neuropathy?

A 
Change in bowel/ bladder habit
Sexual dysfunction
Gustatory sweating
Persistant tachycardia
Postural hypotension
Changes in vision
Changes in respiratory function
Dysphagia
Weight loss
Gastroparesis
23
Q

Outline the management options for autonomic neuropathy

A

Diet changes (increase fibre, reduce fat, portions)
Promotility (metaclopramide, prochlorperazine)
NSAIDs
Atypical analgesia
Botulinum toxin
Gastric pacemaker

24
Q

Outline the investigations that should be carried out to detect neuropathy

A

NCS/ EMG
HR variability
US (bladder, urinary tract)
Gastric emptying studies

25
Q

What screening tools should be used to diagnose diabetic nephropathy?

A

ACR (urinary)
DIpstick test (proteinuria)
U+Es/ monitor serum creatinine

26
Q

What is the target BP for diabetic patients?

A

130/80mmHg

27
Q

Outline the pathogenesis of diabetic nephropathy

A

Angiopathy of capillaries in kidney glomeruli

28
Q

Outline the treatment options for retinopathy

A

Laser
Vitrectomy
Anti-VGEF injection

29
Q

List the drugs that can cause erectile dysfunction

A

Anti-hypertensives (thiazides, beta blockers)

CNS drugs: anti-depressants, tricyclics, SSRIs, sedatives

30
Q

Outline the management options for erectile dysfunction

A

Exercise, weight loss, smoking cessation
PDE inhibitors (sildenafil (viagra), tadalafil, vardenafil)
Refer to andrology clinic (injections, vacuum, surgery)

31
Q

What lifestyle habits in diabetics can increase their risk of complications?

A

Poor glycaemic control
Smoking
Alcohol
Poor diet

Y2 ENDOCRINOLOGY (19 decks)

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