Brainscape's Knowledge GenomeTM

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


See full index

Endocrinology Y2 > Microvascular Complications > Flashcards

Microvascular Complications Flashcards

1
Q

KEY SITES OF MICROVASCULAR COMPLICATIONS: (3)

A
  1. Retinal arteries (eyes)
  2. Glomerular arterioles (kidneys)
  3. Vasa nervorum (tiny blood vessels that supply the nerves)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

FACTORS THAT INFLUENCE RISK/SEVERITY OF COMPLICATIONS: (5)

A
  • Severity of hyperglycaemia
  • Hypertension
  • Genetics
  • Hyperglycaemic memory
  • Tissue damage through originally reversible and later irreversible alterations in protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is hyperglycaemic memory

A

How well controlled your glucose has been from the onset of the diabetes- it does not matter if you now have good control, you will still see repercussions if you had poor control at the start

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

What is the main cause of blindness in people of working age

A

Diabetic retinopathy

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

What is 1st stage diabetic retinopathy known as:

A

Background retinopathy

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

What is 2nd stage diabetic retinopathy known as:

A

pre-proliferative diabetic retinopathy

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

What is 3rd stage diabetic retinopathy known as

A

proliferative retinopathy

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

Are microvascular complications reversible?

A

To an extent, then you’ve fucked it

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

What happens in 1st stage diabetic retinopathy (3)

A
  • Hard exudates (cheese coloured lipid deposits)
  • Microaneurysms (‘dots’)
  • Blot haemorrhages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens in 2nd stage diabetic retinopathy (3)

A
  • Cotton wool spots, also called soft exudates

- Represent retinal ischaemia

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

What happens in 3rd stage diabetic retinopathy (3)

A
  • Visible new vessels on disk or elsewhere in retina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is maculopathy

A

a specific type of retinopathy that effects the macula, involved in colour vision

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

What does the macula do

A

involved in colour vision

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

What happens in maculopathy (3)

A
  • Hard exudates near the macula
  • Same as retinopathy but located around macula
  • Can threaten direct vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MANAGEMENT OF DIABETIC BACKGROUND RETINOPATHY (3)

A
  • Improve glucose control
  • Warn patient that warnings signs are present
  • Retinal screening annually
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MANAGEMENT OF DIABETIC PRE-PROLIFERATIVE RETINOPATHY

A
  • Treatment= PAN RETINAL PHOTOCOAGULATION- burn off parts of the retina using lasers- prevents new vessels forming
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does PRE-PROLIFERATIVE RETINOPATHY show

A

Suggests general ischaemia

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

What happens if nothing is done in PRE-PROLIFERATIVE RETINOPATHY

A

New vessels will grow due to ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MANAGEMENT OF DIABETIC PRE-PROLIFERATIVE RETINOPATHY

A
  • URGENT pan retinal photocoagulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MANAGEMENT OF DIABETIC MACULOPATHY

A

Needs only a GRID of photocoagulation- not PAN retinal, just on the macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features of diabetic nephropathy?

A
  • Hypertension
  • Progressively increasing proteinuria
  • Progressively deteriorating kidney function
  • Classic histological features
22
Q

 People tend to die from X problems following this as diabetic nephropathy increases your risk of X problems hugely

A

cardiovascular

CVS

23
Q

Histological features in the glomerular cells of kidney in diabetic nephropathy (3)

A
  • Mesangial expansion
  • Basement membrane thickening
  • Glomerulosclerosis
24
Q

Incidence of diabetic nephropathy in T1DM?

A

20-40% by 30-40 years

25
Q

Incidence of diabetic nephropathy in T2DM?

A

20-40% by 30-40 years

26
Q

Difference between T1 and T2DM in epidemiology? (3)

A
  1. T2DM is developed at a later age
  2. Racial factors impact nephropathy risk
  3. Loss due to cardiovascular morbidity (they die from macrovascular disease)
27
Q

CLINICAL FEATURES OF DN: (3)

A
  • Progressive proteinuria- use a urine dipstick (nephrotic range >3000mg/24hr)
  • Increased BP
  • Deranged renal function
28
Q

STRATEGIES FOR INTERVENTION FOR DIABETIC NEPHROPATHY: (4)

A
  • Control of the diabetes
  • Blood pressure control- Antihypertensive treatment
  • Inhibition of the RAAS system- ACE inhibitors
  • Cessation of smoking
29
Q

most common cause of neuropathy and therefore of limb amputation in the world is…

A

Diabetes

30
Q

vasa nervorum are…

A

Small vessels supplying nerves

31
Q
  • Small vessels supplying nerves are called ….
A

vasa nervorum

32
Q
  • Neuropathy results when….
A

vasa nervorum get blocked

33
Q

FEATURES OF DIABETIC NEUROPATHY: (6)

A
  • Peripheral neuropathy
  • Mononeuropathy (1 nerve effected)
  • Mononeuritis multiplex (multiple nerves)
  • Radiculopathy (dermatomes effected)
  • Autonomic neuropathy
  • Diabetic Amyotrophy (part of the muscle effected)
34
Q

PERIPHERAL NEUROPATHY IS MOST COMMON IN…

A

Longest nerves supplying feet

35
Q

PERIPHERAL NEUROPATHY causes a…

A

loss of sensation in patients

36
Q

PERIPHERAL NEUROPATHY is more common in…

A

tall people

Patients with poor glucose control

37
Q

The danger in PERIPHERAL NEUROPATHY is….

A

Danger is that patients will not sense an injury to the foot

38
Q

WE TEST SENSATION IN FEET USING ….

A

MONOFILAMENT EXAMINATION

39
Q

What is Charcot’s joint

A
  • Multiple fractures on foot x-ray to diagnose
40
Q

What is MONONEUROPATHY

A
  • Usually sudden motor loss
41
Q

Which areas are usually affected by MONONEUROPATHY

A
  • Wrist drop, foot drop
  • Cranial nerve palsy
  • Double vision due to 3rd nerve palsy
42
Q

What is PUPIL SPARING 3rd NERVE PALSY

A
  • Eye is usually “DOWN AND OUT”
  • (6th nerve pulls eye out and 4th nerve pulls it down)
  • Pupil DOES respond to light
43
Q

In 3rd nerve palsy, if pupil is spared, it’s X or Y, if it’s not spared, it’s probably Z

A

X - diabetes
Y - a vascular disease
Z - a compressive lesion

44
Q

Why is the pupil spared in diabetic neuropathy and not a compressive lesion

A

PS fibres controlling constriction run on the outside of the optic nerve, and are less easily blocked.

However a compressive lesion will block this

45
Q

MONONEURITIS MULTIPLEX is….?

A
  • A random combination of peripheral nerve lesions
46
Q

RADICULOPATHY is…?

A
  • Pain over spinal nerves, usually affecting a dermatome on the abdomen or chest wall
47
Q

AUTONOMIC NEUROPATHY is…?

A
  • Loss of sympathetic and parasympathetic nerves to GI tract, bladder, cardiovascular system
48
Q

AUTONOMIC NEUROPATHY effects on GI tract? (4)

A

Difficulty swallowing
Delayed gastric emptying
Constripation/nocturnal diarrhoea
Bladder dysfunction

49
Q

AUTONOMIC NEUROPATHY effects on CVS? (2)

A

Postural hypotension- can be disabling Collapsing on standing
Cardiac autonomic supply Case reports of sudden cardiac death

50
Q

TESTING FOR AUTONOMIC NEUROPATHY:

A
  • Measure changes in HR in response to VALSALVA MANOEVRE
  • Normally there is a change in HR
  • Look at ECG and compare R-R intervals
51
Q

What is vasalva manouvre?

A

Breathing out with a closed mouth and pinched shut nose

52
Q

What is vasalva manouvre?

A

Breathing out with a closed mouth and pinched shut nose. normally there is an increase in HR

Endocrinology Y2 (18 decks)

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