Microvascular Complications Flashcards

1
Q

name the 2 branched of complications of diabetes

A

macrovascular and microvascular

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2
Q

name the 2 macrovascular complications

A

IHD and stroke

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3
Q

name the 3 microvascular complications

A

neuropathy
nephropathy
retinopathy

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4
Q

what are the 3 other complications of diabetes?

A

dementia
erectile dysfunction
psychiatric

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5
Q

name the 4 types of neuropathy

A

peripheral
autonomic
proximal
focal

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6
Q

what type of neuropathy is the following:

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

A

autonomic

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7
Q

what type of neuropathy is the following:

pain/loss of feeling in feet and/or hands

A

peripheral

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8
Q

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

A

focal

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9
Q

what type of neuropathy is the following:

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

A

proximal

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10
Q

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

A

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

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11
Q

what are the symptoms of peripheral neuropathy?

A
numbness/insensitivity
tingling/burning
sharp pains or cramps
sensitivity to touch
loss of balance and coordination
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12
Q

name the 3 common peripheral neuropathy complications of the foot

A

painless trauma
foot ulcer
Charcot foot

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13
Q

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?

A

charcots foot

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14
Q

painful neuropathy drug treatment?

A

amitriptyline
gabapentine
pregabalin

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15
Q

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

A

focal

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16
Q

focal neuropathy symptoms?

A
inability to focus
double vision
aching behind eye
pain
pain on outside of foot
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17
Q

name the common palsy seen in focal neuropathy

A

Bell’s palsy

18
Q

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

A

Bell’s palsy

19
Q

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

A

proximal neuropathy

20
Q

proximal neuropathy is more common in who?

A

elderly T2DM

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

21
Q

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

A

autonomic neuropathy

22
Q

what is seen in autonomic neuropathy of the digestive system?

A

gastroparesis causing glucose levels to fluctuate

oesophageal nerve damage causing difficulty swallowing

23
Q

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

A

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

24
Q

gastroparesis drug treatment?

A

promotability drugs - metoclopramide, domperidone and erythromycin

anti-nausea - ondansetron

pain - NSAIDS, amitriptyline, gabapentin

botulinum toxin or gastric pacemaker

25
Q

treatment of excessive sweat production sue to autonomic neuropathy?

A

topical glycopyrrolate
clonidine
botulinum toxin

26
Q

name the 4 diagnostic tools for neuropathy

A

nerve conduction/electromyography

heart rate variability

ultrasound

gastric emptying studies

27
Q

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?

A

diabetic neuropathy

28
Q

diabetic neuropathy consequences?

A

hypertension
decline in renal function
GFR reduction
accelerated vascular disease

29
Q

what is used to screen for diabetic kidney disease?

A

urinary albumin creatinine ratio (ACR)

30
Q

nephropathy risk factors?

A
hypertension
cholesterol
smoking
glycaemic control
albuminuria
31
Q

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

A

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

32
Q

state the most common cause of kidney disease/failure

A

diabetes

33
Q

name the 4 eye pathologies as a result of diabetes

A

diabetic retinopathy
cataract
glaucoma
acute hyperglycaemia

34
Q

name the 4 stages of retinopathy

A

mild non-proliferative - RI

moderate non-proliferattive - R2

severe non-proliferative - R3

proliferative - R4

35
Q

optical coherence tomography is used to diagnose and stage what?

A

maculopathy

36
Q

retinopathy treatment?

A

laser
vitrectomy
anti-VEGF injections

37
Q

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

A

erectile dysfunction

38
Q

ED risk factors?

A
diabetes
renal failure
hepatic failure
multiple sclerosis
severe depression
39
Q

name the 2 anti-hypertensive drugs that cause ED

A

thiazides and beta blockers

40
Q

do CNS drugs cause ED?

A

yes