Brainscape's Knowledge GenomeTM

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


See full index

Endo, Cardio and Neuro > Vascular complications of DM > Flashcards

Vascular complications of DM Flashcards

1
Q

what are the microvascular complications of diabetes mellitus?

A

retinopathy
nephropathy
neuropathy

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

what are the macrovascular complications of diabetes mellitus?

A

cerebrovascular disease
ischaemic heart disease
peripheral vascular disease

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

what is the target HbA1c to reduce risk of microvascular complications?

A

53mmol/mol (<7%)

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

what are the other risk factors (besides HbA1c) for complications of diabetes?

A 
duration of diabetes
smoking
genetic factors
hyperlipidaemia
hyperglycaemic memory
hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do we aim to detect retinopathy?

A

theough screening as early stages are asymptomatic

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

describe the appearance of a normal retina

A

optic disk bright spot visible
thin veins semi visible
macula dense/pink spot visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe background retinopathy?

A

hard exudates (white cheesy spots)
microaneuyrsms (dots)
blot haemorrhages
enhanced blood vessels

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

describe pre proliferative retinopathy

A 
more extensive haemorrhage
soft exudates (cotton wool spots)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe proliferative retinopathy

A

new vessels visible

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

describe maculopathy retinopathy

A

hard exudates/oedema near macula
(same as background just near macula)
can threaten vision

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

how do you treat background retinopathy?

A

you can’t.
annual surveillance
lifestyle changes

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

how do you treat pre proliferative retinopathy

A

early panretinal photocoagulation

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

how do you treat proliferative retinopathy?

A

panretinal photocoagulation

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

how do you treat diabetic maculopathy?

A

grid photocoagulation

anti-VEGF injections directly into eye

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

what are the risks of panretinal photocoagulation?

A

loss of some peripheral vision

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

how do you diagnose diabetic nephropathy?

A

urinalysis (microalbuminuria >25.mg/mmol proteinuria (ACR>30mg/mmol), nephrotic range (>3000mg/24hr))
increased blood pressure
eGFR (deranged)

17
Q

what is the mechanism of diabetic nephropathy?

A

hypertension & hyperglycaemia lead to glomerular hypertension
this leads to proteinuria, glomerular &interstitial fibrosis
glomerular filtration rate decline
renal failure

18
Q

what is the renin-angiotensin system?

A

angiotensinogen in liver, kidney produces renin which converts this to angiotensin I
angiotensin converting enzyme converts this to angiotensin II which causes vasoconstriction and release of aldosterone from the zona glomerulosa of the adrenal cortex

19
Q

what is given to prevent further decline of nephropathy?

A

ACE inhibitors (ACEi) or angiotensin-2 receptor blockers (ARB)

20
Q

when are nephropathy treatments prescribed?

A

even when normotensive with microalbuminuria or proteinuria

21
Q

how is nephropathy managed?

A

smoking cessation
tighter glycaemic control
reduce blood pressure via ACEi or A2RB
start SGLT-2 inhibitor if T2DM

22
Q

when does diabetic neuropathy occur?

A

when vasa nervorum get blocked (blood vessels supplying nerves)

23
Q

what are the risk factors of diabetic neuropathy?

A 
age
duration of diabetes
poor glycaemic control
height
smoking
prescence of diabetic retinopathy
24
Q

where is most common for diabetic neuropathy to show?

A

glove&stocking distribution

longest nerves supply feet

25
Q

what is included in annual foot checks?

A 
inspection for foot deformity, ulceration
assess sensation (monofilament, ankle jerks)
assess foot pulses (dorsalis pedis, posterior tibial)
26
Q

when is the risk of ulceration highest?

A

patients with reduced foot sensation

poor vascular supply to feet

27
Q

what is the management of peripheral neuropathy with ulceration?

A 
multidisciplinary diabetes foot clinic
offloading
revascularisation if concomitant PVD
antibiotics if infected
orthotic footwear
amputation
28
Q

presentation of mononeuropathy

A

usually sudden motor loss (foot drop, wrist drop)

cranial nerve palsy - double vision due to 3rd nerve palsy

29
Q

what is autonomic neuropathy?

A

damage to sympathetic & parasympathetic nerves innervating GI tract, bladder, CV system

30
Q

what are the GI effects of autonomic neuropathy?

A

delayed gastric emptying (makes post prandial insulin hard)

constipation/nocturnal diarrhoea

31
Q

how is the CV system affected by autonomic neuropathy?

A 
postural hypertension (collapsing on standing)
cardiac autonomic supply causing sudden cardiac death
32
Q

what are the non-modifiable risk factors for macrovascular complications of DM?

A

age
sex
birth weight
FH/genetics

33
Q

what are the modifiable risk factors for macrovascular complications of DM?

A

dyslipidaemia
hypertension
smoking
central obesity

34
Q

how is CV risk in DM managed?

A 
support smoking cessation
blood pressure control
lipid profiles
weight interventions 
annual microalbuminuria screens

Endo, Cardio and Neuro (22 decks)

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