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Long term complications Improvements in short term treatments of diabetes mean that patients should no longer die from hyperglycaemia or ketoacidotic coma. However, over time long term complications of diabetes may develop in type 1 and type 2 DM. The likelihood that long term complications occur largely depends on the degree of glycaemic control that can be achieved. In addition, it is important to control other risk factors such as obesity, dyslipidaemia and hypertension. With good control and life style the development of long term complications can be delayed or even prevented. MCQs on Long term Complications of diabetes mellitus types 1 and 2. 1. Microalbuminuria should be screened for in diabetes because it is an early indicator of; (Chose 2 correct answers) a. ischaemic heart disease b. superficial infections c. osteomyelitis d. retinopathy e. nephropathy f. neuropathy g. acute renal failure 2. Which of the following vessels may be affected by macrovascualar disease (Chose 3 correct answers) a. coronary arteries b. coronary veins c. femoral arteries d. femoral veins e. carotid artery f. jugular veins g. glomeruli h. retinal capillaries 3. The leading single cause of mortality in long term diabetes is; (Chose 1 correct answer) a. renal failure b. peripheral vascular disease c. pancreatitis d. hepatic cirrhosis e. coronary heart disease f. acute hypoglycaemia 4. The principle pathophysiological change in arterioles, capillaries and venules is; (Chose 1 correct answer) a. atheroma deposition b. atherosclerosis c. arterialsclerosis d. aneurysm e. basement membrane thickening f. medial hypertrophy g. medial hyperplasia 5. Predisposition to infection in poorly controlled diabetes may be explained as a result of; (Chose 3 correct answers) a. increased motility of macrophages b. decreased motility of macrophages c. increased amounts of available bacterial substrate d. decreased amounts of available bacterial substrate e. increased inflammatory reactions f. decreased inflammatory reactions 6. Which of the flowing complications are mainly a consequence of microvascular disease (Chose 2 correct answers) a. ischaemic heart disease b. cerebrovascular haemorrhage c. deep venous thrombosis d. retinopathy e. nephropathy f. neuropathy 7. NICE recommend that all adults with diabetes should reduce the risk of microvascular disease by attaining an HbA1C of; (Chose 1 correct answer) a. more than 11.1% b. more than 9.5% c. between 7.5 and 11.1% d. 7.5% or less e. 5.5% or less 8. NICE recommend that at diagnosis, children and young people with type 1 diabetes should be screened for; (Chose 2 correct answers) a. thyroid disease b. coeliac disease c. Addison's disease d. Cushing's disease e. pancreatitis f. gall stones g. colitis 9. NICE recommend that checks should be carried out annually from the age 12 in all diabetic patients for which conditions; (Chose 3 correct answers) a. retinopathy b. serum cholesterol c. smoking d. central obesity e. Raynaud's disease f. gangrene g. microalbuminuria h. high blood pressure 10. Which of the flowing may help to reduce long term cardiovascular, cerebrovascular and peripheral vascular complications in diabetes; (Chose 4 correct answers) a. smoking b. high polysaturated fat diet c. plenty of aerobic exercise d. maintaining low serum cholesterol e. maintaining high serum cholesterol f. maintaining a high blood pressure g. maintaining a low blood pressure h. avoiding obesity i. restricting fresh fruit