Endo: Macrovascular and Microvascular Complications of Diabetes Flashcards

1
Q

which are the microvascular complications of DM?

A
  • nephropathy
  • retinopathy
  • neuropathy
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2
Q

what does diabetes cause in the kidney

A
  • augmented mesangial matrix production
  • endothelial NO loss
  • VEGF upregulation
    these cause advanced glomerular injury and tubulointerstitial damage
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3
Q

define diabetic nephropathy

A

a decrease in kidnet function with time as a result of uncontrolled diabetes and aggravated by a number of other associated factors

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4
Q

how does diabetic nephropathy progress when it gets more severe

A
  • hypertension increases as kidney function drops
  • albumin excretion peaks at stage 4 but then decreases as the kidney fails
  • GFR goes down the toilet
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5
Q

risk factors for diabetic nephropathy

A
  • genetic predisposition
  • race
  • age
  • obesity
  • smoking
  • increased glomerular filtration rate
  • glycaemic control
  • blood pressure
  • oral contraceptive
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6
Q

how can you monitor nephropathy

A
  • urine protein dipstick

- renal profile

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7
Q

what are management steps that you use in all nephropathy patients?

A

glycaemic and hypertension control

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8
Q

when do you start treating hyperlipidaemia and making protein and salt dietary restrictions

A

Stage 3 onwards

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9
Q

when do you refer to a nephrologist?

A

Stage 5

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10
Q

what is another name for Stage 5 nephropathy?

A

end-stage renal failure

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11
Q

what are the stages of retinopathy

A
  • non-proliferative diabetic retinopathy
  • pre-proliferative diabetic retinopathy
  • proliferative retinopathy
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12
Q

features of non-proliferative diabetic retinopathy

A

pericyte loss, basement membrane thickening, vascular leakage, alterations in blood flow, tissue hypoxia

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13
Q

features of pre-proliferative retinopathy

A

hypoxia, oedema, microaneurysms, soft exudates, venous bleeding

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14
Q

features of proliferative retinopathy

A

angiogenesis, fibrovascular ridge retinal detachment, blindness

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15
Q

types of diabetic neuropathy

A

peripheral and autonomic (GI, CVS, GU)

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16
Q

what are the macrovascular complications of DM?

A

MI, stroke and PVD

17
Q

risk factors to CVD in T2DM

A
  • smoking
  • obesity
  • hypertension
  • hyperlipidaemia
  • hyperglycaemia
18
Q

what are the leading cause of death in diabetics?

A

macrovascular complications like MI, CVA and PVD

19
Q

management of hyperlipidaemia in diabetics

A

always give a statin because the combination of the two is far deadlier than in a person having high cholesterol only

20
Q

management of DM to prevent these from happening

A
  • tight control of glycaemia as well as BP
  • dietary and lifestyle changes
  • exercise
  • medication
  • control dyslipidaemia
21
Q

management of DM complications

A
  • screen regularly
  • involve ophthalmology, podiatry and nephrology
  • provide necessary support services
  • positively motivate and empower patient
22
Q

what is necrobiosis lipodica?

A

atrophic yellow plaques associated with telengiectasia due to hyaline degeneration of collagen

23
Q

what can cause duputren’s contracture?

A

glycation of the collagen and soft tissues with thickening and loss of elasticity

24
Q

what is cheiroarthropathy?

A

limited joint mobility which is mainly found in diabetics

25
what causes cheiroarthropathy?
deposition of advanced glycation endproducts in collagen of periarticular tissues
26
what is cheiroarthropathy associated with?
advanced retinal and renal lesions
27
characteristics of diabetic dermopathy
red papules which scale over and leave atrophic brown scars