Diabetic neuropathy

Question 1

Sensory loss distribution in peripheral neuropathy

Answer 1

Glove and stocking

Lower legs first due to length of sensory neurones supplying this area

Question 2

First line treatment of peripheral neuropathy

Answer 2

Amitryptiline

Duloxetine

Gabapentin

Pregabalin

(if one doesn’t work, try one of the others)

Question 3

Rescue therapy for peripheral neuropathy

Answer 3

Tramadol

Question 4

Treatment of localised neuropathic pain

Answer 4

Topical capsaicin

Question 5

GI autonomic neuropathy examples

Answer 5

Gastroparesis

Chronic diarrhoea (often occurs at night)

GORD

Question 6

Gatroparesis symptoms

Answer 6

Erratic blood glucose control

Bloating

Vomiting

Question 7

Gastroparesis management

Answer 7

Metoclopramide

Domperidone

Erythromycin

(prokinetic agents)

Question 8

Cause of GORD

Answer 8

Decreased LES pressure