Vascular complications of diabetes

Question 1

Leading cause of ESRD (end stage renal disease) in the US.

Answer 1

Nephropathy

Question 2

Leading indicator of developing nephropathy

Answer 2

MICROALBUMINURIA - Refers to the appearance of small but abnormal amounts of albumin in the urine.
30-300mg/24hours

Question 3

Drugs to help Nephropathy

Answer 3

ACEI – Ace Inhibitors (angiotension converting enzyme inhibitors)

ARB’s – (Angiotension II receptor blockers)

Question 4

Retinopathy - Proliferative

Answer 4

Neovascularization (growth of new vessels).
Extend between the retina and vitreous.
Can lead to sudden vision loss
Neovascular glacoma
Blind, painful eye
Retinal detachment  (floaters)
Senile cataracts
Snowflake lens opacities

Question 5

Retinopathy - Nonproliferative

Answer 5

Increased capillary permeability.
Dilation of venules.
Presence of microaneurysms.
Appear as dots.
Hard exudates (yellow deposits of proteins and lipids).
Superficial retinal microinfarcts – cotton wool spots.

Question 6

Autonomic neuropathy

Answer 6

Gastric dysmotility - Gastroparesis
Orthostatic Hypotension
Bladder involvement
Erectile dysfunction

Question 7

Somatic Neuropathy: Peripheral polyneuropathy

Answer 7

Most common
Glove and stocking distribution
Pain
Numbness
Hyperethesias – increase in sensitivity
Paresthesias – burning, itching, tingling
Eventual sensory loss (Loss of proprioception, Loss of vibratory sense)

Question 8

Mononeuropathies

Answer 8

Focal limb or cranial nerve:
Present acutely and are self limiting
Cranial nerves commonly involved
CN 3,4,6, and 7
Limb commonly femoral, sciatic, or peroneal neuropathy

Question 9

Diabetic amyotrophy

Answer 9

Muscle atrophy and weakness
Anterior thigh
Pelvic girdle

Question 10

PRIMARY SITES of PVD

Answer 10

Femoral & Popliteal arteries: 80-90%

Tibial & Peroneal arteries: 40-50%

Aorta & Iliac arteries: 30%