Signs and Symptoms

Question 1

What are the symptoms of hypercalaemia?

Answer 1

• Excess urine

- Musculoskeletal symptoms

Question 2

What is the main symptom of diabetes insipidus?

Answer 2

Causes excess dilute urine (lack of ADH)

Question 3

What does a burning sensation at penis tip indicate?

Answer 3

Could be due to candida balanitis, fungal infection for which hyperglycaemia is a risk.

Question 4

What are the symptoms of hyperglycaemia?

Answer 4

• Thirst
• Polyuria
• Polyphagia
• Tiredness
• Weight loss

Question 5

What are the signs of painful neuropathy?

Answer 5

In feet: burning, cold, tingling, stabbing, walking on glass, contact sensitvity, allodynia (one sensation translated into another), numbness, restlessness, worse at night, eased by exercise or counter irritation

Question 6

What pathologies can occur during diabetic neuropathy?

Answer 6

• Foot ulcers
• Calluses and blisters
• Damage to skin allowing bacteria to enter e.g. Staph aureus - can result in cellulitis and lymphangitis and progress to septicaemia
• Local impact of inflammation on arterial circulation > thrombosis > neuro-ischaemic ulcer, cellulitis and pre-gangrene
• Necrotising cellulitis
• Osteomyelitis - secondary to infected diabetic foot ulceration
• Charcot neuropathy - bone weakens in foot - deformity/disability/amputation
• Distal PVD

Question 7

What complications can occur in the hands?

Answer 7

• Cheiroarthropathy - thickened skin and reduced joint mobility in hands and fingers
• Dupuytren’s contracture
• Carpel tunnel syndrome

Question 8

What are the clinical features of DKA?

Answer 8

• Hyperventilation - metabolic acidosis
• Vomiting- ketosis and hyperglycaemic gastric stasis
• Dehydration - osmotic diuresis and vomiting
• Hypotension with warm peripheries - dehydration and vasodilation
• Decreased conscious level - severe hypotension (CV shock)
• Abdominal pain

Question 9

What are the signs of severe hypoglycaemia?

Answer 9

• Adrenergic symptoms - sweating, trembling, hunger

- Neuroglycopenia - parasthesiae, blurred vision, confusion

Question 10

Who is at risk of developing severe hypoglycaemia?

Answer 10

• Alcohol excess
• Very young or old
• Long duration DM
• Recent severe hypoglycaemia
• Pregnancy (early)
• Autonomic neuropathy
• Renal or hepatic impairment