DIABETIC NEUROPATHY

Question 1

major etiology of diabetic neuropathy?

Answer 1

hyperglycemia

• ischemic
• metabolic
• autoimmune

Question 2

what should be controlled to reduced neurologic complications?

Answer 2

hyperglycemia

Question 3

what are the hyperglycemia causes?

Answer 3

nerve ischemia
glycosylation of nerve protein
decrease uptake of nerve myoinositol
decreased activity of sodium potassium ATPase pump
reduction of axonal transport

Question 4

three categories of diabetic neuropathy?

combinations lead to significant clinical manifestations like?

Answer 4

sensory neuropathy
motor neuropathy
autonomic neuropathy

excessive stresses on tissue
formation of mechanical keratosis
undetected tissue breakdown

Question 5

prolonged periods of hyperglycemia lead to impairment of immune function like?

*immunopathy consists of:

Answer 5

deficits in phagocyte system

*decrease in chemotaxis to the site of infection

decrease in phagocytosis

decreased intracellular killing of microorganisms

any combo of the three

Question 6

major roles of macrophages in wound healing?

Answer 6

phagocytosis, antimicrobial fxn
wound debridement
cell recruitment and activation
angiogensis
matrix synthesis, regulation

Question 7

how does immunopathy affect the tx of the patient?

Answer 7

antibiotics should include drugs that are bactericidal

bacteriostatic agents require an intact immune system

frequent antibiotics lead to colonization with resistant species of organisms

Question 8

what is the clinical significance of angiopathy?

Answer 8

gangrene, which is good for infection, including anaerobes, deceased perfusion leads to decreased local antibiotic concentration

Question 9

what are the wound types?

Answer 9

neuropathic (mal perforans)
ischemic
gangrenous (dry vs wet)
decubitus (pressure)
venous

Question 10

what are the wound care principles?

Answer 10

infection management
perfusion
offloading
edema management
wound bed management