CM: Diabetes Complications Flashcards Preview

Block 8 - Endo & Repro > CM: Diabetes Complications > Flashcards

Flashcards in CM: Diabetes Complications Deck (11):
1

What are the findings of non-proliferative diabetic retinopathy?

microaneurysms
capillary non-perfusion
leakage --> blood andv (hard) exudates (macular edema can lead to loss of visual acuity)

2

What are the findings of pre-proliferative diabetic retinopathy?

intra-retinal microvascular abnormalities (IRMA)
intra-retinal hemorrhages
cottons wool spots = soft exudates
venous bleeding

3

What are the findings of proliferative diabetic retinopathy?

new vessels = neovascularization (fine tufts)
fibrous tissue
vitreous hemorrhage
traction retinal detachment

4

When should follow up visits for pts w diabetes be conducted?

annually - children, adolescents, adults w/o retinopathy
semi-annually: non-proliferative retinopathy
quarterly: pre-proliferative
individualized: proliferative, pregnant

5

What are important early findings in diabetic nephropathy?

BP elevation
microalbuminuria
hyperfiltration (CCr above normal)
alterations in glomerular structure (BM thickening and mesangial expansion)

6

How can microalbuminuria be detected?

dipstick negative, albumin excretion 30-300 mg/24 hrs (30-300 microg/min), found in 2 of 3 urine samples w/i 6 mos
should look for 5 yrs after diagnosis of type 1 and at diagnosis of type 2

7

What can cause transient microalbuminuria?

poor glycemic control, UTI, physical exercise, high protein intake, cardiac insufficiency

8

What are the features of distal symmetrical polyneuropathy?

paresthesias (tingling, numbness), pain, impaired sensation (vibratory, pain), nocturnal exacerbation, absent knee and ankle reflexes
motor involvement variable

9

What are the features of neuropathic ulcers?

caused by loss of protective sensation and repetitive trauma
over areas w increased pressure
hammer-claw toe deformity of foot --> increased pressure on metatarsal heads

10

What are the risk factors for the dev of diabetic neuropathy?

genetic predispostion, male gender, height, alcohol, hyperglycemia

11

How can one examine a pt for subclinical diabetic neuropathy?

quantitative sensory tests:
vibratory perception threshold - measures large nerve fiber integrity, better in upper limbs
thermal perception threshold - measures small nerve fiber integrity
also tactile perception threshold and electrical threshold