Module 8- Diabetes and Vascular Disease

Question 1

____% of people with DM have wounds

Answer 1

15

Question 2

14-24% of those with diabetic ulcers will ultimately have an_____

Answer 2

amputation

Question 3

Mortality following amputation increases with level of amputation and range from 50-85% at ____ Years

Answer 3

5

Question 4

hyper-______ can lead to stiffer blood vessels and reduced tissue oxygenation

Answer 4

hyperglycemia

Question 5

Type 1 DM- after 20 years of disease duration at least 20% have ____

Answer 5

diabetic peripheral neuropathy

Question 6

Type 2 DM- after 10 years of disease duration at least 50 % have ____

Answer 6

diabetic peripheral neuropathy

Question 7

with diabetic peripheral neuropathy loss of sensation manifests as a decrease in what

Answer 7

decreased sensation, vibration, proprioception, loss of reflexes

Neuropathic pain

Question 8

diabetic peripheral neuropathy how does motor change

Answer 8

progressive weakness and atrophy

Question 9

What autonomic changes occur in diabetic peripheral neuropathy

Answer 9

decreased sweat and oil production—> leads to dry inelastic skin
orthostasis
Silent MI

Question 10

____ is the most common complication of DM type I and II

Answer 10

diabetic peripheral neuropathy

Question 11

when completing a monofilament test for DM what sensation are you testing

Answer 11

protective sensation

Question 12

progressive degeneration of weight-bearing joints
-increase risk of skin breakdown

Answer 12

Charcot disease

Question 13

What are 3 common foot deformities in charcot disease

Answer 13

1. claw toe deformity
2. bunion and overlapping toes
3. rocker-bottom deformity secondary to charcot arthopathy

Question 14

What are 4 complications of vascular and neuropathic changes

Answer 14

1. ulceration- often painless
2. neuropathic edema
3. charcot arthropathy
4. callus formation

Question 15

up to 50% of patients with type 2 DM are at an _____ risk of developing skin infections

Answer 15

increased

Question 16

how does the skin change with diabetes

Answer 16

loss of elasticity
commonly a shiny appearance
thick skin

most common in hands and fingers

Question 17

Where is the most common spot for diabetic yellow skin

Answer 17

palms of hands, soles of feet and distal nail plate

Question 18

what is the most common cutaneous change present in 30-60% of pts with DM
usually seen in men >50 years old

Answer 18

diabetic dermopathy

Question 19

Explain the presentation of diabetic dermopathy

Answer 19

round/oval atrophic
hyperpigmented raised lesions
usually on the pretibial are of LE
can occur on the forarms

initially small, dull red, scaly papules and small plaques

Question 20

Xerosis is dryness of the skin with fissures/cracks most commonly found on heels and feet this is an area at risk of ____

Answer 20

infection

Question 21

development of dark, thick, velvety skin in body folds and creases

most common in axilla, groin, posterior neck

Answer 21

acanthosis nigricans

Question 22

acquired perforating dermatosis presentation

Answer 22

large papules with central keratin plugs
usually on limbs of adults, usually LEs

Question 23

Describe the two cutaneous reactions to insulin

Answer 23

lipotrophy- occurs within 6-24 months of starting treatment
most common in children and women

Liphypertrophy- resembles lipoma