Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

203 - Theme 1 - The Endocrine System > L18 - Long term Diabetic Complications > Flashcards

L18 - Long term Diabetic Complications Flashcards

1
Q

Microvascular complications (3)

A

Retinopathy

Nephropathy

Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Macrovascular complications (3)

A

IHD

CVD

PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mechanism of microvascular complications

A

Most cells are able to reduce glucose transport in response to extracellular hyperglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cells involved in microvascular complications

A

Retinal endothelial cells

Mesangial cells of glomerulus

Schwann cells and peripheral nerve cells

These 3 types of cells cannot control how much glucose is transported into the cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many years can it take for microvascular complications to arise?

A

Many years

Rare before 5 years of type 1

May be detected at presentation of type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Retinopathy prevalence and risk

A

Second commonest cause of blindness in those of working age

4000+ in England blind from diabetic retinopathy

Risk of blindness increased 10-20 fold by DM

Glaucoma and cataract increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is retinopathy?

A

Destruction of the retinal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The retinal microcirculation

A

Low density of capillaries

  • little functional reserve
  • flow needs to respond to local needs
  • pericytes key to local regulation of flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pathological findings of diabetic retinopathy

A

Loss of pericytes

Basement membrane thickening

Capillary closure

Ischaemia

  • VEGF production
  • Increased capillary permeability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical stages of retinopathy

A

Non-proliferative

  • background
  • pre-proliferative

Proliferative

Muscular oedema

  • sight threatening
  • non sight threatening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is important to control in diabetic retinopathy?

A

Diabetic control

Blood pressure control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatments available for diabetic retinopathy

A

Laser treatment

  • pan retinal
  • focal

Intra-vitreal anti VEGF Ab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prevalence of Neuropathy

A

Affects up to 50% of diabetic patients

15% have painful neuropathy (cf 5% non-diabetic population)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Types of neuropathy

A

Peripheral neuropathy

Mononeuropathy

Autonomic neuropathy

(Entrapment neuropathy increased)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Peripheral neuropathy

A

Affects hands and feet - numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of peripheral neuropathy

A

Neuropathic ulcer

Callus

Charcot foot

17
Q

Mononeuropathy definition

A

Only a single nerve is damaged

e.g. only one eye affected

18
Q

Autonomic neuropathy

A

Gastroparesis

Postural hypotension

Erectile dysfunction

Gustatory sweating

Diarrhoea

19
Q

Nephropathy prevalence

A

Commonest cause of ESRD in Western world

Accounts for deaths of 21% of type 1 and 11% of type 2 patients

20
Q

The renal microcirculation

A

Fenestrated glomerular capillaries

Basement membrane

Highly specialised podocytes

21
Q

Pathological findings of diabetic nephropathy

A

Basement membrane thickening
-loss of negative charge

Podocyte loss
-loss of integrity of filtration barrier

Glomerular sclerosis

Mesangial expansion

22
Q

Clinical stages of diabetic nephropathy

A

Normoalbuminuria
-dipstick negative

Microalbuminuria (20-200ug/min or 30-300mg/24hrs)
-dipstick negative

Albuminuria (>200ug/min or >300mg/24hrs)

  • dipstick positive
  • declining GFR
23
Q

Diabetic nephropathy

A

BP control important

Blockers of RAS system preferred

Glucose control important but less so once overt proteinuria

Associated with increased CVD risk

Ultimately renal replacement/transplantation

24
Q

Microvascular disease

A

Dramatic increase in risk with diabetes

Patients with type 2 diabetes have multiple RFs

Patients with type 1 diabetes have long disease duration

Presentation depends upon vascular bed affected

  • angina/MI
  • stroke
  • PVD
25
Q

Modifiable risk factors for microvascular disease

A

Blood pressure

Lipids

Smoking

(Glucose control)

26
Q

Diabetic foot

A

Diabetes is the commonest cause of non-traumatic lower limb amputation

  • PVD
  • Neuropathy (neuropathic ulcer, charcot change)
  • Impaired leucocyte function
27
Q

UKPDS

A

The better you control your blood sugar level and BP, the less chance to develop microvascular disease

28
Q

DCCT

A

The better you control HbA1c the less chance to develop microvascular complications

203 - Theme 1 - The Endocrine System (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions