Diabetes Photo Quiz

Question 1

Major predictors of vascular complications

Answer 1

• Duration
• A1C
• BP
• Lipids (Macro)

Question 2

Area of greatest pressure in feet

Answer 2

2nd metatarsal

Question 3

Red, painful or nonpainful, swollen, deformed foot in person w/ Diabetes

Answer 3

Acute Charcot’s Neuropathic Arthropathy

Question 4

Differentiate Charcot vs Osteomyelitis

Answer 4

• Involvement of Bone vs only Joint

- presence of Ulcer

Question 5

Chronic Charcoat vs superimposed infx?

Answer 5

MRI -> Marrow edema indicates infx/Osteomyelitis

Question 6

S/S Non-proliferative diabetic retinopathy

Answer 6

• Microaneurysms
• Cotton-wool spots
• Blurred vision w/ “Floaters”

Question 7

• Erythematous macule w/ clear borders, central yellowing or ulceration in person w/ diabetes
• Tx?

Answer 7

NLD

Necrobiosis Lipoidica Diabeticorum

Tx: Steroids, ASA, and Dipyridamole combo; photoTx, cyclosporin, biologics

Question 8

Skin manifestation of uncontrolled Hypertriglyceridemia in diabetics; Appearance?

Answer 8

Eruptive Xanthoma

Itchy, nodular to pustular lesions on Buttocks/knees

Question 9

What is Acanthosis Nigricans A/S? Possible causes other than DM?

Answer 9

• Insulin resistance

- Malignancy, Niacin, Birth control, + Corticosteroids

Question 10

• Spontaneous non-inflammatory blistering in diabetics

Answer 10

Bullosis Diabeticorum

Question 11

Chronic dark non-pruritic skin macules in LE which are not affected by steroid creams in individuals w/ Diabetes

Answer 11

Diabetic dermopathy “Shin spots”

Question 12

• “Prayer position” difficulty
• Cannot put hands together; trouble with insulin injection
• Path?
• A/S?

Answer 12

Diabetic Stiff skin (Digital Sclerosis)

Reaction of glucose w/ proteins in skin

A/S Dupuytren contracture

Question 13

• Fullness w vomiting of undigested food in person w/ diabetes.
• PAth?
• Diagnosis?
• Tx?

Answer 13

Diabetic Gastroparesis

• Autonomic neuropathy leading to vagal nerve damage
• XRay, Manometry, gastric emptying study
• Metoclopramide, Low residue diet, Erythromycin, Jejunostomy, TPN

Question 14

• Urinary retention w/ overflow in person w/ diabetes

- Path?

Answer 14

• Neurogenic bladder

- Detrusor underactivity