neuropathies Flashcards
the 4 types of nephropathies?
peripheral, focal, autonomic and proximal
which one responsible for changes in bladder, bowel, erectile problems, sweating, hr, BP
autonomic
which is a sudden weakness in one nerve or nerve group?
focal neuropathy
which type f neuropathy is carpal tunnel?
focal
which type of neuropathy is bells palsy?
focal
what sort of symptoms can you get in a peripheral neuropathy?
burning, stinging, numbers, insensitivity, sharp pains, cramps, sensitivity to touch, loss of balance/co ordination (CHECK SOLES)
three complications of peripheral neuropathy? (think feet)
charcot foot, painless trauma (nail through foot) and ulcer
pain in thighs/hips/buttocks leading to weakness in legs (amyotrophy)
proximal neuropathy
how can you treat pain in neuropathy?
amitryptaline
focal neuropathies appear suddenly and affect specific nerves. where do you most often get them?
head, torso, leg
what is gastroparesis?
slow gastric emptying
most common symptoms of oesophageal nerve damage?
dysphagia
example of 2 pro motility drugs?
metoclopramide and domperidone
what ratio can you use to screen for diabetic kidney disease?
urinary creatinine ratio (ACR)
what should blood pressure be maintained at in all patients with diabetes?
less than 130/80
what should patients with microalbuminuria or proteinuria be commenced on?
an ACE inhibitor or ARB
acute hyperglycaemia can do what to vision?
blurring
what other eye conditions are more common in diabetes?
glaucoma and cataract
stages of retinopathy?
Mild, moderate and severe NON PROLIFERATIVE retinopathy. and proliferative retinopathy
how is proliferative diabetic retinopathy defined?
neovascularization. Greater potential for serious visual consequences
how do you get hard exudates?
get fluid deposition under the macula. Resolution of this fluid can leave behind hard exudates, like a receding river after a flood
you get loss of which type of cells in the capillaries?
pericytes
as npdr progresses, the affected vessels may become obstructed. this obstruction leads to infarction of the nerve fibre layer. This results in?
fluffy white patches known as cotton wool spots
what does VEGF stimulate?
growth of new blood vessels
what is wrong with the new blood vessels?
they are leaky, fragile and misdirected. they can grow out of the retina and in to the vitreous
