Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FA17 Endocrine > Diabetes Complications > Flashcards

Diabetes Complications Flashcards

(52 cards)

Start Studying
1
Q

Main complications of DM

A 
Microvascular 
Macrovascular 
Opthamology 
Neuropathy 
Nephropathy 
OB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Microvascular complications

A

Damage to small vessels of organs

Esp. Diabetic opthalmopathy and diabetic nephropathy

Related to glycemic control

T1DM

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

Macrovascular

A

Arteriosclerosis of large vessels

CAD, MI, stroke, peripheral vascular disease

Related to both glycemic control and lipid/HTN

T2DM

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

Chronic complications of DM

A

Cigarette smoking

T1DM - high rates of ESRD and proliferative retinopathy

T2DM - high rates of MI and CVA

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

Lipid protein abnormalities in T1DM

A

Moderate hyperglycemia can cause SLIGHT elevation of LDL and TAG, little change in HDL

Not a big deal

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

Lipid protein abnormalities in T2DM

A

Distinct dyslipidemia develops

High serum TAGs
Low HDL cholesterol
High artherogenic LDL

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

Lipid goals DM

Who gets lifestyle coaching?

A

Prevention of macrovascular complications is dependent on control of dyslipidemia and HTN

All should have lifestyle coaching

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

First line treatment of dyslipidemia

A

Statins given at a moderate or high intensity dose

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

high risk DM

LDL and TG goals

A

LDL: <100 mg

TG: <150 mg

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

very high risk DM

LDL and TG goals

A

LDL: <70mg

TG: <150

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

CV complications of DM

A

diabetes is a coronary heart disease risk equivalent

T1 DM pts develop microvascular dz with congestive HF

T2 DM pts develop microvascular disease (CAD, CVA, PAD)

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

primary CVD recommendations

A

Lower BP <130/80

consider EC ASA

continued diet adherence

exercise 150 min/week

smoking cessation

lower LDL <100

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

two main categories of retinopathy

A

nonproliferation

proliferative

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

nonproliferation retinopathy

A

microaneurysms, exudates, intra-retinal hemorrhages, edema, arteriolar ischemia

manifested as cotton wool spots

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

proliferative retinopathy

A

neovascularization on retina, optic disc, or iris

leads to hemorrhage, fibrosis and retinal detachment

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

DM ocular complications

A

leaving cause of blindness in adults < 74

increased in AA and Hispanics

accelerated by poor glycemic control

presence of nephropathy is protective of retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

20% of T2DM patients have retinopathy at time of diagnosis bc

A

insidious development

doesn’t come in to get tested until it is bad

rare in T1DM, but happens to all eventually

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

when is a dilated eye exam

A

annual

5 years after diagnosis (T1DM)

at time of diagnosis (T2DM)

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

ocular complication screenings early for which patients (3)

A
  1. pregnant women (+ 1yr postpartum)
  2. existing retinopathy
  3. treatment for macular edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

symptoms of retinopathy

A

floaters, blurred vision and loss of visual acuity

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

prevention of DM retinopathy

Study These Flashcards
A

A1c levels at less than 7%

glycemic control, smoking cessation, HTN control

22
Q

cataracts DM

Study These Flashcards
A

longstanding diabetes as well as poorly controlled DM

req. surgical management and lens replacement

23
Q

macular edema DM

Study These Flashcards
A

20% of T2

fluid and protein collects in central retina (macula) causing blurring and loss of central vision

24
Q

glaucoma DM

Study These Flashcards
A

6% of DM

responsive to usual open angle therapy

25
diabetic nephropathy epidemiology
DM is leading cause of ESRD in US more often in T1DM detectable at first as microalbuminuria, then goes to proteinuria
26
DM nephropathy is caused by
glomerular basement membrane thickening mesangial sclerosis diabetic glomeruloscreotic changes cause vascular stress, protein leak and GFR decline
27
first sign of nephropathy
microalbuminuria 30-300 mg/protein/day potentially reversible
28
proteinuria
continued poor glucose control causes GFR decline > 300 mg/24 hrs
29
diabetic nephropathy screening
done annually with albumin to creatine ratio (random urine sample)
30
preferred treatment for DM nephropathy
ACE inhibitors + control of HTN can use ARBs
31
ACE inhibitors and ARBS
protect agains renal deterioration in T1DM with nephropathy seem to improve glomerular hemodynamics recommended for all DM patients with HTN or normotensive pts with microalbuminuria only use one must be stopped if Cr >2 persistent K+ >6 mEq/L
32
consequences of DM nephropathy
acceleration of coronary cerebral arteriosclerosis and hypertension we can really only slow course to ESRD microalbuminuria independently predicts CV morbidity
33
mc diabetic complication
neuropathy 1. distal symmetric polyneuropathy 2. isolated peripheral neuropathy 3. painful diabetic neuropathy 4. autonomic neuropathy
34
distal symmetric polyneuropathy
MC form presents in stocking glove patterns due to axonal neuropathic process sensory involvement - dulled perception of vibration, temperature, and pain denervation of small muscles of foot alter biomechanics of foot and increase plantar pressures causes ulcerations
35
common sign of distal symmetric polyneuropathy
charcot's foot joint subluxation and periarticular fractures if untreated progresses into rocker bottom must do daily foot inspection, appropriate footwear distributing weight, meticulous hygiene
36
DM foot ulcers in well vascularized limb
unloading debridement of wound potential need for ABX
37
DM foot ulcers in poorly vascularized limb
revascularization if infected -pt will need amputation
38
isolated peripheral neuropathy
sudden loss of function of nerve/nerves subsequent slow recovery of all or most function involves either one nerve (mononeuropathy) or multiple nerves in one area (mononeuropathy multiplex)
39
causes of isolated peripheral neuropathy
vascular ischemia and traumatic damage cranial/femoral nerves freq. involved predominance of motor abnormalities
40
painful DM neuropathy
hypersensitivity to light touch, occasionally severe burning pain, most often in lower extremities occurs particularly at hight
41
diabetic neuropathic chacexia
profound and rapid weight loss and unrelenting pain treat with insulin to improve DM control and analgesics (difficult to successfully treat)
42
general DM neuropathy treatments
no effective treatments to reverse DM neuropathy once present better glycemic control, lipid, HTN control to prevent progression protection of feet, thearpy/strengthening exercises and surgical deformities
43
drug treatment of painful DM neuropathy
anti epileptic drugs (pregabalin/lyrica) antidepressants topical agents
44
autonomic neuropathy manifestations
postural hypotension GI autonomic neuropathy inability to fully empty bladder erectile dysfunction
45
symptoms and treatment of autonomic neuropathy postural hypotension
dizziness, orthostasis, syncope TED hose, Florinef
46
symptoms and treatment of autonomic neuropathy GI autonomic neuropathy
gastroparesis (slow emptying) E-mycin, gastric stimulator) alternating diarrhea and constipation (antidiarrheals. clonidine, or fiber therapies)
47
symptoms and treatment of autonomic neuropathy inability to fully empty bladder
urinary retention bethanechol, self cauterization
48
peripheral vascular disease
both PAD and venous status very important bc no blood flow = inability to carry antibiotics (limbs will die) accelerated in large vessels
49
how does venous stasis manifest itself by
dryness and flakey skin redness
50
prevention and treatment of PVD
smoking cessation glycemic control management of BP and lipids screen PAD by checking pulses and ABI tests
51
gangrene of foot why foot?
uncontrolled sugar (bacteria food) decreased blood supply neuropathy more common in DM bc of endothelial issues
52
gangrene of food control
glycemic control daily care of feet proper footwear avoidance of agents (i.e. tobacco) HTN control treatment of dyslipidemia revascularization

FA17 Endocrine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions