Microvascular Complications

Question 1

name the 2 branched of complications of diabetes

Answer 1

macrovascular and microvascular

Question 2

name the 2 macrovascular complications

Answer 2

IHD and stroke

Question 3

name the 3 microvascular complications

Answer 3

neuropathy
nephropathy
retinopathy

Question 4

what are the 3 other complications of diabetes?

Answer 4

dementia
erectile dysfunction
psychiatric

Question 5

name the 4 types of neuropathy

Answer 5

peripheral
autonomic
proximal
focal

Question 6

what type of neuropathy is the following:

changes in bowel, bladder function, sexual response, sweating, heart rate, blood pressure

Answer 6

autonomic

Question 7

what type of neuropathy is the following:

pain/loss of feeling in feet and/or hands

Answer 7

peripheral

Question 8

what type of neuropathy is the following:

sudden weakness in one nerve or a group of nerves causing muscle weakness or pain e.g. carpal tunnel, ulnar mono neuropathy, foot drop, bells palsy, cranial nerve palsy

Answer 8

focal

Question 9

what type of neuropathy is the following:

pain in the thighs, hips or buttocks leading to weakness in the legs (amyotrophy)

Answer 9

proximal

Question 10

a patient with T_DM is more likely to have neuropathy as a complication

Answer 10

a patient with T1DM is more likely to have neuropathy as a complication

Question 11

what are the symptoms of peripheral neuropathy?

Answer 11

numbness/insensitivity
tingling/burning
sharp pains or cramps
sensitivity to touch
loss of balance and coordination

Question 12

name the 3 common peripheral neuropathy complications of the foot

Answer 12

painless trauma
foot ulcer
Charcot foot

Question 13

a condition causing weakening of the bones in the foot that can occur in people who have significant neuropathy - the bones are weakened enough to fracture and the foot eventually changes shape defines what?

Answer 13

charcots foot

Question 14

painful neuropathy drug treatment?

Answer 14

amitriptyline
gabapentine
pregabalin

Question 15

what neuropathy appears suddenly and often affects the head, torso or leg?

Answer 15

focal

Question 16

focal neuropathy symptoms?

Answer 16

inability to focus
double vision
aching behind eye
pain
pain on outside of foot

Question 17

name the common palsy seen in focal neuropathy

Answer 17

Bell’s palsy

Question 18

name the condition that causes a temporary weakness or paralysis of the muscles in the face

Answer 18

Bell’s palsy

Question 19

lumbosacral plexus neuropathy, femoral neuropathy and diabetic amyotrophy are all types of what neuropathy?

Answer 19

proximal neuropathy

Question 20

proximal neuropathy is more common in who?

Answer 20

elderly T2DM

proximal muscle weakness
marked weight loss
starts with pain in thighs one one side of body

Question 21

what type of neuropathy affects nerves that regulate heart rate and blood pressure and those that control internal organs?

Answer 21

autonomic neuropathy

Question 22

what is seen in autonomic neuropathy of the digestive system?

Answer 22

gastroparesis causing glucose levels to fluctuate

oesophageal nerve damage causing difficulty swallowing

Question 23

there is persistent ________ and ________, bloating and loss of ________ in gastroparesis

Answer 23

there is persistent NAUSEA and VOMITING, bloating and loss of APPETITE in gastroparesis

Question 24

gastroparesis drug treatment?

Answer 24

promotability drugs - metoclopramide, domperidone and erythromycin

anti-nausea - ondansetron

pain - NSAIDS, amitriptyline, gabapentin

botulinum toxin or gastric pacemaker

Question 25

treatment of excessive sweat production sue to autonomic neuropathy?

Answer 25

topical glycopyrrolate clonidine botulinum toxin

Question 26

name the 4 diagnostic tools for neuropathy

Answer 26

nerve conduction/electromyography heart rate variability ultrasound gastric emptying studies

Question 27

a progressive kidney disease caused by damage to the capillaries in the kidneys' glomeruli - characterized by nephrotic syndrome and diffuse scarring of the glomeruli defines what?

Answer 27

diabetic neuropathy

Question 28

diabetic neuropathy consequences?

Answer 28

hypertension decline in renal function GFR reduction accelerated vascular disease

Question 29

what is used to screen for diabetic kidney disease?

Answer 29

urinary albumin creatinine ratio (ACR)

Question 30

nephropathy risk factors?

Answer 30

``` hypertension cholesterol smoking glycaemic control albuminuria ```

Question 31

patients with microalbuminuria or proteinuria should be commenced on an ___ _________ or an ___

Answer 31

patients with microalbuminuria or proteinuria should be commenced on an ACE INHIBITOR or an ARB

Question 32

state the most common cause of kidney disease/failure

Answer 32

diabetes

Question 33

name the 4 eye pathologies as a result of diabetes

Answer 33

diabetic retinopathy cataract glaucoma acute hyperglycaemia

Question 34

name the 4 stages of retinopathy

Answer 34

mild non-proliferative - RI moderate non-proliferattive - R2 severe non-proliferative - R3 proliferative - R4

Question 35

optical coherence tomography is used to diagnose and stage what?

Answer 35

maculopathy

Question 36

retinopathy treatment?

Answer 36

laser vitrectomy anti-VEGF injections

Question 37

name the vascular and neuropathic cause of dysfunction seen in 50% of diabetic men

Answer 37

erectile dysfunction

Question 38

ED risk factors?

Answer 38

``` diabetes renal failure hepatic failure multiple sclerosis severe depression ```

Question 39

name the 2 anti-hypertensive drugs that cause ED

Answer 39

thiazides and beta blockers

Question 40

do CNS drugs cause ED?

Answer 40

yes