T2DM P2

Question 1

Signs and symptoms

Answer 1

• weight loss
• blurred vision
• slow healing wounds
• recurrent uti UTI
• excessive thirst
• sweet smelling urine

Question 2

What is the primary prevention of cholesterol in those who have 10% risk of developing CVD?

Answer 2

Atorvastatin 20mg daily

Question 3

What is the dose of Atorvastatin in established CVD

Answer 3

80mg

Question 4

Which statins are lipophilic, thus more likely to myophathy as an ADR

Answer 4

Atorvastant and simvastatin

Question 5

What are the symptoms of Peripheral vascular disease

Answer 5

• change in skin colour - pale/blue
• cold limbs

Question 6

What examinations would you do for PAD

Answer 6

• capillary refill time
• check for ulceration
• temperature of limbs
• listen for any abnormal sounds in arteries
• check pulses

Question 7

What drugs are used for PAD treatment and prevention

Answer 7

Prevention - clopidogrel 75mg
Treatment - naftidrofuryl 100mg TDS

Question 8

Which part of the nervous system is affected by neuropathy

Answer 8

Stoma sensory nervous system

Excitable/continous fired signal

Question 9

Management of painful diabetic neuropathy

Answer 9

Step1
• paracetamol

Step 2
• 1st line - duloxitine

If pain is severe/persistant
1. Refer to specialist
2. Tamadol (if CI use lidocaine)

Question 10

Management of other neuropathic pain

Answer 10

Step 1
• paracetamol

Step 2
• 1st line: gabapentin or amitriptyline
• 2nd line: use one which has not been used

Question 11

What is autonomic neuropathy Gastroparesis?

Answer 11

Damage to the nerve (vagus) responsible for GIT function

Question 12

What are the signs and symptoms of Gastroparesis?

Answer 12

• feeling full
• N&V
• abdominal pain

Question 13

What examinations are needed for diagnosis

Answer 13

• endoscopy
• abdominal imaging
• presence of symptoms

Question 14

1st line management of Gastroparesis is diet. What would you recommend?

Answer 14

• avoid spicy
• increase fibre intake

Question 15

2st line management of Gastroparesis prokinetics . What would you recommend?

Answer 15

They help GI motility

• mirtazipine
• erythromycin
• domperidone
• metoclopramide

Question 16

Describe diabetic nephropathy?

Answer 16

Increase in blood glucose, damages the surrounding blood vessels of nephron and tubules, affecting nephrons ability to filter waste effectively

Question 17

Creatinine is used in the prognosis. What does it test for?

Answer 17

Measures how well the kidneys are wintering waste

High levels = impaired kidney function
Low levels = decreased kidney function

(Also for prognosis - urine albumin test)

Question 18

What is the treatment of nephropathy

Answer 18

ACE inhibitor and SHLT2 inhibitor + bicarbonate supplement

Question 19

What drug is used for weight gain management?

Answer 19

Tripeptide - tirzepatide

Question 20

What two peptides are made up in tirzepatide

Answer 20

GIP and GLP1

Question 21

Smocking cessation management options?

Answer 21

•NRT
• e-cigarettes
• bupropion

Question 22

What are the general long term monitoring of type 2 diabetes?

Answer 22

• BMI
• blood pressure
• HbA1c
• cholesterol
• smocking cessation
• eye screening
• foot examinations
• kidney function
• urinary albumin

Question 23

What results of HbA1c is diabetics

Answer 23

> 48

Question 24

What fasting blood glucose is considered diabetic?

Answer 24

> 7

Question 25

If HbA1 is over >48 and no symptoms are present, when to repeat again

Answer 25

After 3 months

Question 26

Self monitoring is usually not advised, unless..

Answer 26

• on insulin
• on sulphonylureas
• using heavy machinery
• pregnant