Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PM3B > (PM3B) Diabetes Complications > Flashcards

(PM3B) Diabetes Complications Flashcards

1
Q

How is mortality increased with diabetes complications?

A

Increase in prevalence of cardiovascular disease and renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is morbidity increased with diabetes complications?

A
  • Diabetic foot
  • Retinopathy
  • Peripheral neuropathy
  • Peripheral vascular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the short-term complications of diabetes?

A

(1) Hypoglycaemia
(2) Diabetic ketoacidosis - DKA
(3) Hyperosmolar Hyperglycaemic State - HHS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the long-term complications of diabetes?

A

(1) Retinopathy
(2) Cardiovascular disease
(3) Neuropathy
(4) Peripheral vascular disease
(5) Nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does hypoglycaemia occur?

A

When blood glucose falls below 4mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can hypoglycaemia lead to if not treated? c u c

A
  • Convulsions
  • Unconsciousness
  • Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the potential causes of hypoglycaemia?

A

(1) Too much injected insulin
(2) Altered insulin ABSORPTION
(3) Altered insulin CLEARANCE
(4) Decreased insulin requirement
(5) Failure to recognise symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is hypoglycaemia treated?

A

If conscious: 10-20g of glucose

If unconscious: IM/ SC glucagon OR IV glucose (dextrose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

(1) What is nocturnal hypoglycaemia?

(2) How can it be recognised?

A

(1) Blood glucose <4mmol/L at night

(2) Waking up tired/ with a headache/ wet from sweating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What advice can be given to diabetic patients experiencing hypoglycaemia? p bg at g dct

A

(1) Look for patterns - adjust insulin accordingly
(2) More regular blood glucose monitoring
(3) Avoid triggers - e.g. alcohol
(4) Carry glucose tablets/ sweets
(5) Diabetes Care Team

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does alcohol decrease blood sugar?

A

Inhibits glycogen breakdown + release in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

(1) What is diabetic ketoacidosis (DKA)?

(2) When is it most common?

A

(1) Use of fats + proteins as an energy alternative to glucose. Causes a build up of ketones, leading to acidosis.

(2) Type 1 diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What most commonly causes DKA?

A

Infections - 40%
Diabetes diagnosis - 10-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the effect of infection on insulin requirements for a diabetic patient?

A

Can increase insulin requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the most severe symptoms of DKA?

A

Diabetes symptoms with greater severity
- Thirst
- Polyuria
- Tiredness
- Blurry vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the less frequent symptoms of DKA? n c ap lb u ph d

A
  • Nausea
  • Cramp
  • Abdominal pain
  • Laboured breathing
  • Unconsciousness
  • Postural hypotension
  • Dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment for DKA?

A

(1) IV rehydration - 0.9% saline
(2) Insulin infusion - to correct hyperglycaemia
(3) Correction of electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In DKA, which electrolyte is most likely to be affected?

How is it affected?

A

Potassium

Decreases - hypokalaemia

19
Q

What is HHS? me. hbg, d

A

Hyperosmolar Hyperglycaemic State

  • Occurs in T2DM
  • Medical emergency
  • Very high blood glucose levels
  • Severe dehydration
20
Q

What causes HHS?d ai

A
  • Diuretics
  • Acute illness
21
Q

(1) When is ketone build-up observed in the urine?

(2) In which similar condition is it NOT present? Why?

A
  • DKA
  • HHS - because some insulin is produced in T2DM
22
Q

What are the symptoms of HHS?

A

ø Polyuria
ø Thirst
ø Nausea + vomiting
ø Dry skin
ø General weakness
ø Leg cramps
ø Visual impairment
ø Confusion
ø Drowsiness + unconsciousness
ø Can lead to coma

23
Q

What are the diagnostic symptoms of HHS?

A

(1) Very high blood glucose (>30mmol/L)
(2) Low ketone levels in urine (<3mmol/L)
(3) No acidosis
(4) Hyperosmolality

24
Q

What is more common, DKA or HHS?

A

DKA is more common

25
Q

What is the treatment for HHS? 4. i i a p

A
  • IV fluids
  • IV low-dose insulin
  • Anticoagulant - HHS is associated with vascular thrombosis
  • Prevention of foot ulceration
26
Q

Which comorbidities does HHS increase risk of?

A

(1) Vascular (arterial/ venous) thrombosis
(2) Foot ulceration - increases susceptibility to pressure sores

27
Q

How can the complication of cardiovascular disease be minimised in diabetic patients? w e s sc bp

A
  • Reduce weight
  • Exercise
  • Statins (>40yrs old)
  • Maintain BP in normal range (<130/85mmHg)
  • Smoking cessation
28
Q

How is diabetic neuropathy caused? bv nd

A

Diabetes + poor glycaemic control affects the blood vessels supplying the nerves

Leads to nerve damage - neuropathy

29
Q

What are the types of neuropathy associated with diabetes?

A

(1) SENSORY - numbness in extremities

(2) AUTONOMIC - Incontinence, erectile dysfunction, resting tachycardia, gastroparesis (delayed gastric emptying)

(3) MOTOR - Muscle weakness, muscle degradation, muscle twitching, cramp

30
Q

How is diabetic foot ulceration caused? pc nd

A

Poorly managed diabetes leads to poor circulation and nerve damage

31
Q

How can the skin of a diabetic patient often present? d c le i

A
  • Dry
  • Cracked
  • Lacking elasticity
  • More prone to injury
  • Infected
32
Q

Why are people with diabetic foot at increased risk of amputation? 3

A

(1) Ulceration of foot can lead to infection
(2) Often not felt due to nerve damage (neuropathy)
(3) Slow to heal due to poor circulation

33
Q

What preventative management options are there for a diabetic patient attempting to avoid foot ulceration?

A

(1) Wash with soap
(2) Dry thoroughly
(3) Keep nails trimmed - podiatrist/ chiropodist
(4) Keep skin healthy - podiatrist/ chiropodist
(5) Wear fitting shoes
(6) Annual clinical foot examination

34
Q

What are the treatment options for each type of neuropathy, relating to diabetes?

A

(1) Sensory - analgesia

(2) Motor - Physiotherapist - Prevent muscle degradation

(3) Autonomic
- Sildenafil - specifically indicated for erectile dysfunction
- Antiemetics - specifically indicated for nausea + vomiting (gastroparesis)

35
Q

What is retinopathy?

A

Damage to the retina

36
Q

How is retinopathy caused?

A

Weak blood vessels bleed onto the retina

Blind spots form due to leakage

37
Q

What preventative management options are there for diabetic patients protecting against retinopathy?

A

(1) Annual eye screening
(2) Maintenance of normal blood glucose
(3) Maintenance of normal BP (<130/85mmHg)
(4) Maintenance of normal LDL + HDL levels
(5) Seek medical help if vision changes

38
Q

What is the treatment for diabetic retinopathy?

A

(1) Laser surgery - improves circulation

(2) Anti-VEGF intra-ocular injection - prevents inappropriate blood vessel growth

(3) Intra-ocular corticosteroid implant - inhibit inflammation

39
Q

How common is nephropathy in diabetic patients?

A

25-50% of all diabetics

40
Q

How is nephropathy caused in diabetic patients?

A
  • Hyperglycaemia damages small blood vessels supplying the kidney
  • Poor blood supply affects kidney function
  • Leads to nephropathy
41
Q

How can the complication of nephropathy be reduced in diabetic patients?

A
  • Annual kidney function test (protein presence indicates damage)
  • Maintenance of normal blood glucose
  • Maintenance of normal BP (<130/85mmHg)
  • Smoking cessation
42
Q

What is the treatment for diabetic nephropathy?

A

(1) Management of BP and blood glucose

(2) 1st Line: ACEi and ARBs

(3) Diet modification - low salt, limited proteins

(4) Dialysis

(5) Kidney transplant - if kidney function is poor

43
Q

What is the first line treatment for nephropathy in diabetic patients?

A

ACE inhibitors and Angiotensin II Receptor blockers

PM3B (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions