Diabetes

Question 1

Management of type II diabetes

Answer 1

Conservative: Weight loss, Exercise, Improved diet
Medical: Metformin, Sulphonylurea, Pioglitazone, DPP4-inhibitor, Insulin

Question 2

Common diabetic complications

Answer 2

Retinopathy, Nephropathy, Foot ulcers

Question 3

Signs of neuropathic foot ulcer

Answer 3

Clawed toes, Dry skin, On pressure points

Question 4

Signs of vascular foot ulcer

Answer 4

Absent pulses, Reduced capillary refill, Cold limb, Positive Beurger’s sign, Absent hair

Question 5

Investigations for foot ulcers

Answer 5

ABPI, Swabs, X-ray

Question 6

Management of foot ulcers

Answer 6

Conservative: Remove callus, Specialised footwear
Medical: Antibiotics (flucloxacillin)
Surgical: Angioplasty, Amputation

Question 7

Investigations for diabetic nephropathy and findings

Answer 7

Urine dipstick - microalbuminuria

Question 8

Management of diabetic nephropathy

Answer 8

ACE inhibitors

Question 9

Fundoscopy signs of diabetic retinopathy

Answer 9

Microaneurysms, Haemorrhages, Hard exudates

Question 10

Management of diabetic retinopathy

Answer 10

Intervitreal Anti-angiogenics and Steroids

Question 11

Causes of hyperosmolar non-ketotic syndrome

Answer 11

Infection, Poor diabetes management, Diuretics

Question 12

Symptoms of hyperosmolar non-ketotic syndrome

Answer 12

Dry mouth, Polydipsia, Polyuria, Confusion, Leg cramps, Hallucinations, Drowsiness, Weakness, Blurred vision, Seizures, Coma

Question 13

Signs of hyperosmolar non-ketotic syndrome

Answer 13

Tachycardia, Hypotension, Tachypnoea, Loss of skin turgor

Question 14

Investigations for hyperosmolar non-ketotic syndrome

Answer 14

Bloods: Glucose, U+Es, FBC, Culture

Urine dip, ECG, CXR

Question 15

Blood findings with hyperosmolar non-ketotic syndrome

Answer 15

FBC: signs of infection
U+Es: High urea, Electrolyte imbalance
Glucose: high

Question 16

Management of hyperosmolar non-ketotic syndrome

Answer 16

Conservative: IV rehydration
Medical: Insulin, Replace K, Heparin

Question 17

Causes of diabetic ketoacidosis

Answer 17

First presentation, Poor control, Infection, Antipsychotics, Chemotherapy

Question 18

Complications of diabetic ketoacidosis

Answer 18

Cerebral oedema, Hypokalaemia, Thromboembolism

Question 19

Symptoms of diabetic ketoacidosis

Answer 19

Abdominal pain (cramp), Vomiting, Nausea, Confusion, Drowsiness, Polyuria, Polydipsia, Coma

Question 20

Signs of diabetic ketoacidosis

Answer 20

Tachypnoea, Tachycardia, Hypotension, Ketotoic breath, Dry mucus membranes, Loss of skin turgor

Question 21

Investigations for diabetic ketoacidosis

Answer 21

Bloods: FBC, U+Es, Plasma osmolarity, Ketones, Glucose

ABG, ECG, Urine dip

Question 22

Blood findings with diabetic ketoacidosis

Answer 22

FBC: signs of infection
U+Es: Raised Urea, Hypo/hypernatraemia
Raised glucose, Raised osmolarity

Question 23

Management of diabetic ketoacidosis

Answer 23

Conservative: IV fluids
Medical: Fixed rate Insulin, K replacement

Question 24

Symptoms of hypoglycaemia

Answer 24

Confusion, Headache, Double/Blurred vision, Dizziness, Palpitations, Tremor, Paraesthesis, Seizure, Coma

Question 25

Signs of hypoglycaemia

Answer 25

Sweating, Tachycardia, Dilated pupils, Pallor

Question 26

Management of hypoglycaemia

Answer 26

IV dextrose, IV glucagon