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03- Endocrine > Microvascular Complications > Flashcards

Microvascular Complications Flashcards

1
Q

diabetes id the leading cause of what three ailments?

A

blindness

dialysis

amputation of the lower limbs

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2
Q

what are the types of neuropathy?

A

peripheral

autonomic

proximal

focal

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3
Q

describe peripheral neuropathy?

A

pain/loss of feeling in feet, hands

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4
Q

what are some complications of peripheral neuropathy?

A

charcot foot

painless trauma e.g stepping on nail without noticing

foot ulcers

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5
Q

what is another name for charcot foot?

A

osteoarthropathy

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6
Q

what is charcot foot?

A

disorgansied joint

loss of bone

multiple fractures

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7
Q

what can be done in charcot foot?

A

in acue painful hot joint use biphosphonate drugs

orthotic shoes

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8
Q

loss of blanace and coordination can occur in which neuropathy?

A

peripheral

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9
Q

describe autonomic neuropathy?

A

chnages in bowel, bladder function, sexual response, sweating, HR, BP

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10
Q

what effect does autonomic neuropathy have on the digestive system?

A

constipation/diarrhoea

gastroparesis (slow stomach emptying)- persistent nausea, vomiting, bloating

oesophagus nerve damage- can make swalowing difficult

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11
Q

does gastroparesis affect blood glucose?

A

yes- blood glucose levels can fluctuate widely due to abnormal food digestion

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12
Q

how do you treat gastroparesis?

A

improved glycaemic control

dietary- smaller portions

promotility drugs e.g metoclopramide

gastric pacemaker

botilnum toxin

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13
Q

which neuropathy causes abnormalities in the sweat glands?

A

autonomic

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14
Q

how are the sweat glands affected in autonomic neuropathy?

A

body cannot refulate its temperature so sweats at irregular time- profusely at night or while eating

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15
Q

how would you treat gustatory sweating in autonomic neuropathy?

A

topical glycopyrrolate

clonidine

botulinum toxin

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16
Q

describe proximal neuropathy?

A

pain in the thighs, hips, buttocks leading to weakness in the legs

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17
Q

what is teh name given to the weakiening of the legs in proximal neuropahthy?

A

amyotrophy

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18
Q

who is proximal neuropathy most common in?

A

elderly people with T2DM

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19
Q

proximal neuropathy is commonly associated with what?

A

weight loss

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20
Q

describe focal neuropathy?

A

sudden wekaness in one nerve or group of nerves casuign muscle weakness

21
Q

what are some examples of focal neuropathy?

A

carpal tunnel

ulnar mono neuropathy

foot drop

bells palsy

cranial nerve palsy

22
Q

focal neuropathy appears suddenly/gradually?

A

suddenly

23
Q

what are the treatment options fro painful neuropathy?

A

amitriptyline

duloxetine

gabapentin

topical capsaican cream

24
Q

what are some of the diagnostic tools used for neuropathy?

A

nerve conduction studies/ electromyography

heart rate variability

ultrasound

gastric emptying studies

25
Q

what is diabeteic nephropathy?

A

progressive kidney disease caused by damage to capillaries in the kidneys glomeruli

26
Q

diabetic nephropathhy is also known as?

A

kimmelsteil-Wilson syndrome

nodular glomerulosclerosis

27
Q

what are the consequences of diabetic nephropathy?

A

development of hypertension

decline in renal funcion

accelerated vascular disease

28
Q

which ratio is used to screen for diabetic kidney disease?

A

urinary albumin creatinine ratio (ACR)

29
Q

what is the urine ACR in microalbuminuria for males and females?

A

males: 2.5-25
females: 3.5-35

30
Q

what are ther risk factors for nephropathy progression?

A

hypetension

cholesterol smoking

glycaemic control

albuminuria

31
Q

what is the target for BP in pateints with diabetes?

A

130/70

32
Q

blood pressure should be maintained at _/_ in patients with diabetes?

A

<130/80mmHg

33
Q

what eye pathologies do people with diabetes get?

A

retinopathy

cataract

glaucoma

acute hyperglycaemia (visual blurring)

34
Q

what is a cataract?

A

clouding of the lens

35
Q

what is a glaucoma?

A

increase in fluid pessure in the eye leading to optic nerve damage

36
Q

which structure in the eye contains the most cones and allows us to see what is striaght in front of us?

A

macula

37
Q

what are the stages of retinopathy?

A

mild non-proliferative (backgorund)

moderate non-proliferative

severe non-proliferative

proliferative

38
Q

what are hard exudates in the eye?

A

lipid breakdown products

39
Q

what are ischaemic areas in the eye called?

A

cotton wool spots

40
Q

what are haemorrages in the eye called?

A

dot/flame/blot

41
Q

what does IRMA stnad for?

A

Intra-retinal microvascular abnormalities

42
Q

retinopathy and maculopathy are graded together/seperately?

A

seperately

43
Q

mild background retinopathy encompasses what?

A

haemorrages and microaneurysms

44
Q

pre proliferative retinopathy encompasses what?

A

haemorrages, micro aneurysms, hard exudates

45
Q

severe non-proliferatve retinopathy encompasses what?

A

haemorrages, IRMA, venous bleeding

46
Q

what is the mainstay treatment for retinopathy?

A

laser therapy

also vitrectomy, anti-VEGF injections

47
Q

what is a vitrectomy?

A

surgical removal of the vitreous gel layer of the eye

48
Q

how do anti- VEGF drugs work?

A

stopping vascular endothelial growth factor protein from working- prevents new blood vessel growth

49
Q
A

03- Endocrine (9 decks)

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