Type 1 Diabetes Mellitus Overview
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Questions and Answers

What primarily leads to the onset of Type 2 Diabetes Mellitus (T2DM)?

  • Autoimmune destruction of pancreatic beta cells
  • Genetic factors and lifestyle choices (correct)
  • Prolonged insulin therapy
  • Chronic kidney disease

    • Which complication is NOT directly associated with prolonged hyperglycemia in diabetes?

  • Chronic Obstructive Pulmonary Disease (COPD) (correct)
  • Neuropathy
  • Diabetic Ketoacidosis (DKA)
  • Retinopathy

    • What is a common risk factor for complications in diabetic patients?

  • Optimal blood glucose control
  • Prolonged hyperglycemia (correct)
  • Low carbohydrate diet
  • Regular physical activity

    • Which of the following statements about diabetic nephropathy is accurate?

    <p>It leads to kidney damage due to elevated blood sugar levels.</p> Signup and view all the answers

    Which treatment strategy is essential for the management of Type 2 Diabetes Mellitus?

    <p>Regular monitoring of blood glucose and lifestyle changes</p> Signup and view all the answers

    What does chronic hyperglycemia primarily damage in diabetic patients?

    <p>Retinal vessels</p> Signup and view all the answers

    What type of health complications does Type 2 Diabetes Mellitus notably increase the risk of?

    <p>Macrovascular complications</p> Signup and view all the answers

    What is a symptom of diabetic hyperglycemia?

    <p>Fatigue</p> Signup and view all the answers

    What indicates a diagnosis of type 1 diabetes mellitus (T1DM)?

    <p>Low C-peptide levels</p> Signup and view all the answers

    Which of the following is NOT a method used for early diagnosis of diabetic complications?

    <p>Blood gas analysis</p> Signup and view all the answers

    Which statement accurately reflects the management of diabetes complications?

    <p>Maintaining blood pressure and lipid levels is critical.</p> Signup and view all the answers

    What is a characteristic of diabetic neuropathy?

    <p>It leads to numbness, tingling, and pain.</p> Signup and view all the answers

    What is a significant finding in urinalysis that suggests a possible diabetes diagnosis?

    <p>Presence of glucose and ketones</p> Signup and view all the answers

    What condition can result from the body breaking down fat for energy in individuals with Type 1 Diabetes Mellitus?

    <p>Diabetic Ketoacidosis</p> Signup and view all the answers

    Which of the following indicates an autoimmune response in Type 1 Diabetes Mellitus?

    <p>Presence of GAD antibodies</p> Signup and view all the answers

    What is a key symptom of Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)?

    <p>Severe dehydration and confusion</p> Signup and view all the answers

    Which serious complication can arise from untreated Diabetic Ketoacidosis (DKA)?

    <p>Coma</p> Signup and view all the answers

    What is the typical emergency treatment for someone with Diabetic Ketoacidosis?

    <p>IV insulin, fluids, and electrolyte management</p> Signup and view all the answers

    In Type 2 Diabetes Mellitus, what happens when the pancreas exhausts its beta cells?

    <p>Impaired insulin secretion</p> Signup and view all the answers

    What role does dysfunctional adipose tissue play in Type 2 Diabetes Mellitus?

    <p>It releases inflammatory cytokines</p> Signup and view all the answers

    What triggers episodes of Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)?

    <p>Severe dehydration or infections</p> Signup and view all the answers

    What is a common result of chronic high blood sugar associated with diabetes?

    <p>Retinopathy</p> Signup and view all the answers

    Which component is NOT a typical symptom of Diabetic Ketoacidosis (DKA)?

    <p>Low blood pressure</p> Signup and view all the answers

    What is the primary structural change observed in acute glomerulonephritis?

    <p>Increased cellular proliferation in the glomerular tuft</p> Signup and view all the answers

    Which of the following accurately describes a nephron's primary function?

    <p>Filtration of blood and waste secretion</p> Signup and view all the answers

    What most likely characterizes nephrotic syndrome?

    <p>Inflammation due to primary glomerular injury</p> Signup and view all the answers

    Which mechanism is primarily involved in pre-renal failure?

    <p>Disruption of renal blood supply</p> Signup and view all the answers

    What role does the Loop of Henle play in nephron function?

    <p>Concentration of urine through water re-absorption</p> Signup and view all the answers

    Which type of hypersensitivity reaction is commonly associated with nephrotic syndrome?

    <p>Type III hypersensitivity</p> Signup and view all the answers

    What is considered a major consequence of acute kidney injury (AKI)?

    <p>Tubular necrosis and decrease in GFR</p> Signup and view all the answers

    Which cells are primarily involved in the cellular proliferation seen in acute glomerulonephritis?

    <p>Endothelial, mesangial, and epithelial cells</p> Signup and view all the answers

    Which of the following best describes the renal corpuscle's role in nephron function?

    <p>Filtration of blood to form urine</p> Signup and view all the answers

    What factors contribute to intra-renal failure?

    <p>Direct damage to nephrons</p> Signup and view all the answers

    What does prolonged hyperglycemia primarily affect in patients with diabetes mellitus?

    <p>Small blood vessels</p> Signup and view all the answers

    Which symptom is NOT typically associated with Type 1 Diabetes Mellitus?

    <p>Hyperactivity</p> Signup and view all the answers

    What complication is characterized by kidney damage in diabetic patients?

    <p>Diabetic Nephropathy</p> Signup and view all the answers

    Which of the following statements about Diabetic Ketoacidosis (DKA) is true?

    <p>It may include symptoms like fruity-smelling breath.</p> Signup and view all the answers

    Which intervention is crucial to prevent complications associated with prolonged hyperglycemia in older adults?

    <p>Prompt medical intervention</p> Signup and view all the answers

    What is a major risk associated with the development of Diabetic Retinopathy?

    <p>Blurred vision and floaters</p> Signup and view all the answers

    In assessing the pathophysiology of Type 2 Diabetes Mellitus (T2DM), what role do cytokines play?

    <p>They lead to increased insulin resistance.</p> Signup and view all the answers

    Which of the following is a common result of untreated diabetic complications?

    <p>Cardiovascular disease</p> Signup and view all the answers

    What is the effect of gut hormone changes in diabetes management?

    <p>They can worsen glucose regulation.</p> Signup and view all the answers

    What early symptoms are indicative of severe cases of Type 1 Diabetes Mellitus?

    <p>Nausea, abdominal pain, and rapid breathing</p> Signup and view all the answers

    What does the RIFLE classification system specifically measure in relation to Acute Kidney Injury?

    <p>Serum creatinine levels, GFR, and urine output</p> Signup and view all the answers

    Which factor is crucial for initiating the recovery process in Acute Kidney Injury?

    <p>Removal of the causative agent of kidney damage</p> Signup and view all the answers

    Which statement is true regarding the expected outcomes of kidney function recovery after Acute Kidney Injury?

    <p>GFR shows a permanent reduction of 1-3% which is not clinically significant.</p> Signup and view all the answers

    In the context of prerenal acute kidney injury, which strategy would primarily be utilized for treatment?

    <p>Correction of fluid volume deficits and optimizing cardiac function</p> Signup and view all the answers

    What is a primary purpose of monitoring fluid and electrolyte imbalances in patients with acute kidney injury?

    <p>To collect serum electrolyte levels and assess physical symptoms of complications</p> Signup and view all the answers

    What is the role of myofibroblasts in the pathophysiology of chronic kidney disease?

    <p>They produce extracellular matrix.</p> Signup and view all the answers

    What is a common early sign of chronic kidney disease?

    <p>Muscle twitches and cramps</p> Signup and view all the answers

    Which treatment option is considered the best for end-stage renal disease?

    <p>Kidney transplantation</p> Signup and view all the answers

    What process is primarily involved in the loss of intrinsic renal cells in chronic kidney disease?

    <p>All of the above</p> Signup and view all the answers

    Which factor contributes most significantly to the need for renal replacement therapy in chronic kidney disease?

    <p>Progressive loss of kidney function</p> Signup and view all the answers

    What is the preferred method for vascular access in haemodialysis?

    <p>Arteriovenous fistula</p> Signup and view all the answers

    Which of the following is NOT typically involved in the pathophysiological changes leading to chronic kidney disease?

    <p>Stimulation of erythropoiesis</p> Signup and view all the answers

    Which of the following primary diseases is most commonly associated with chronic kidney disease (CKD)?

    <p>Diabetes mellitus type 2</p> Signup and view all the answers

    What type of kidney injury is primarily characterized by obstructive processes?

    <p>Postrenal failure</p> Signup and view all the answers

    Which factor is NOT a component of the pathophysiology of chronic kidney disease?

    <p>Sudden renal perfusion pressure drop</p> Signup and view all the answers

    Which renal function test is essential for assessing kidney effectiveness in waste clearance?

    <p>Creatinine clearance</p> Signup and view all the answers

    What is the primary goal of reducing the metabolic rate in patients with renal impairment?

    <p>Reduce endogenous waste products</p> Signup and view all the answers

    What is a key rationale for practicing asepsis in the care of patients with chronic kidney disease?

    <p>To reduce risk of sepsis</p> Signup and view all the answers

    Which intervention can help mitigate skin complications in patients with chronic kidney disease?

    <p>Good skin hygiene practices</p> Signup and view all the answers

    What would be an expected outcome of treatment with haemodialysis in patients with renal failure?

    <p>Elimination of urea and creatinine from the blood</p> Signup and view all the answers

    Which chronic disease is linked to the intrinsic renal pathology leading to CKD?

    <p>Chronic glomerulonephritis</p> Signup and view all the answers

    In assessing CKD complications, which of the following should the nurse prioritize for patient education?

    <p>Psychological support resources</p> Signup and view all the answers

    What initiates the micturition reflex when the bladder is distended?

    <p>Activation of stretch receptors in the bladder wall</p> Signup and view all the answers

    Which muscle is responsible for the voluntary control of urination?

    <p>External sphincter</p> Signup and view all the answers

    What is the primary function of the kidneys in the urinary system?

    <p>Maintaining homeostasis by controlling fluid and electrolyte balance</p> Signup and view all the answers

    What is the process by which urine is transported from the ureter to the bladder?

    <p>Peristaltic waves from ureter wall contraction</p> Signup and view all the answers

    Which hormone produced by the kidneys is primarily responsible for stimulating red blood cell production?

    <p>Erythropoietin</p> Signup and view all the answers

    In the context of kidney function tests, what could deranged values indicate?

    <p>Potential kidney disease or dysfunction</p> Signup and view all the answers

    Which of the following best describes the anatomical location of the kidneys?

    <p>Retroperitoneally on the posterior wall of the abdomen</p> Signup and view all the answers

    What is the primary function of the detrusor muscle during urination?

    <p>To contract and facilitate urine expulsion</p> Signup and view all the answers

    What role does renin play in the body?

    <p>Regulates blood pressure via the renin-angiotensin-aldosterone system</p> Signup and view all the answers

    What is the primary waste product removed from the body through urine?

    <p>Metabolic waste and toxins</p> Signup and view all the answers

    What primarily maintains sterility in the urinary tract?

    <p>The flushing action of urine</p> Signup and view all the answers

    Which symptom is NOT commonly associated with lower urinary tract infections?

    <p>Loin pain with systemic symptoms</p> Signup and view all the answers

    How does E. coli typically enter the urinary tract?

    <p>From fecal contamination at the urethral opening</p> Signup and view all the answers

    What is the main inflammatory condition resulting from pathogenic microbes in the urinary tract?

    <p>Urethritis</p> Signup and view all the answers

    Which of the following factors can lead to increased risk of urinary tract infections?

    <p>Compromised mechanical or chemical defenses</p> Signup and view all the answers

    What specific role does the antibody IgA play in the bladder?

    <p>Providing immune protection</p> Signup and view all the answers

    In elderly patients, what symptom may be an atypical presentation of a urinary tract infection?

    <p>Confusion</p> Signup and view all the answers

    What mechanism helps prevent the colonization of the urinary tract by pathogens?

    <p>Flushing due to urine flow</p> Signup and view all the answers

    What is a common feature of dysuria experienced during a urinary tract infection?

    <p>Pain during urination</p> Signup and view all the answers

    Which bacteria is commonly associated with urinary tract infections due to its presence in bowel flora?

    <p>E. coli</p> Signup and view all the answers

    Study Notes

    Type 1 Diabetes Mellitus

    • Rapidly presents with symptoms due to acute insulin deficiency
    • Symptoms include:
      • Polyuria (increased urination)
      • Polydipsia (excessive thirst)
      • Polyphagia (increased hunger)
      • Unexplained weight loss
      • Fatigue
    • Severe cases can lead to Diabetic Ketoacidosis (DKA)
      • Symptoms: nausea, abdominal pain, rapid deep breathing (Kussmaul respirations), fruity-smelling breath, and altered mental status
    • Diagnosis involves:
      • Blood glucose testing (fasting plasma glucose ≥126 mg/dL or random plasma glucose ≥200 mg/dL)
      • Haemoglobin A1c (HbA1c) levels of 6.5% or higher
      • Urinalysis may show glucose and ketones
      • Autoantibody testing confirms autoimmune beta-cell destruction
      • Low C-peptide levels indicate insufficient insulin production, consistent with T1DM
    • Timely diagnosis and management are essential to prevent acute and chronic complications

    Diabetic Ketoacidosis (DKA)

    • Occurs with insufficient insulin
    • Body breaks down fat for energy, producing ketones
    • Causes metabolic acidosis, dehydration, and electrolyte imbalances.
    • Symptoms include:
      • Extreme thirst
      • Frequent urination
      • Nausea
      • Vomiting
      • Abdominal pain
      • Rapid breathing with a "fruity" odour
      • Fatigue
      • Confusion
    • If untreated, DKA can lead to coma or organ failure
    • Emergency treatment involves hospitalisation with IV insulin, fluids, and electrolyte management.

    Type 2 Diabetes Mellitus

    • Primarily caused by genetic factors and lifestyle choices, such as poor diet, inactivity, and obesity.
    • Leads to insulin resistance and elevated blood sugar levels.
    • Over time, the pancreas may become insufficient in insulin production.
    • Insulin resistance arises when muscle, liver, and adipose tissue cells become less responsive to insulin, often due to obesity, reducing glucose uptake.
    • Initially, the pancreas compensates by increasing insulin production, but over time, beta cells become exhausted.
    • The liver continues to produce excess glucose, worsening hyperglycemia.
    • Dysfunctional adipose tissue releases inflammatory cytokines that further promote insulin resistance, while changes in gut hormones disrupt glucose regulation.
    • Prolonged hyperglycemia can lead to complications like retinopathy, nephropathy, neuropathy, cardiovascular disease, and peripheral artery disease.
    • Understanding T2DM's pathophysiology is essential for effective management and lifestyle interventions.

    Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

    • Severe complication of Type 2 Diabetes.
    • Often triggered by infections or dehydration.
    • Occurs when blood sugar exceeds 600 mg/dL, causing severe dehydration and confusion without significant ketone production.
    • Key symptoms include:
      • Excessive thirst
      • Frequent urination
      • Potential seizures
    • Treatment involves:
      • IV fluids
      • Insulin therapy
      • Electrolyte management
    • Prompt intervention is essential to prevent organ failure or death, particularly in older adults.
    • Early treatment can enable full recovery.

    Retinopathy

    • Results from chronic hyperglycemia, damaging retinal blood vessels and risking blindness.
    • Early detection through regular eye exams is crucial.

    Nephropathy

    • Kidney damage from elevated blood sugar, leading to protein leakage and potential kidney failure.
    • Regular monitoring of kidney function and urine protein is vital for early intervention.

    Neuropathy

    • Affects peripheral nerves, causing numbness and increasing the risk of foot ulcers.

    Macrovascular Complications of Diabetes Mellitus

    • Type 2 Diabetes Mellitus increases the risk of macrovascular complications that affect large blood vessels, leading to serious health issues.
    • Prolonged high blood sugar causes disorders.

    ### Nephron

    • Demonstrate understanding of the structure and function of the nephron.
    • Each nephron consists of two parts: renal corpuscle and a renal tubule.
    • The nephrons are the functional units of the kidneys.
    • Nephrons and collecting ducts perform three basic functions:
      • Filtration of the blood
      • Re-absorption of water and solutes
      • Secretion of wastes from the blood.
    • Filtered liquid passes through the proximal convoluted tubule, Loop of Henle (nephron loop) and distal convoluted tubule.

    Acute Kidney Injury (AKI)

    • Discuss the cause of pre, intra and post renal failure, discuss the pathophysiology of AKI.
    • Pre-renal occurs upstream of the kidneys due to renal blood supply disruptions
    • Pre-renal is caused by renal ischaemia, causing a decrease in GFR and tubular necrosis.
    • Intra-renal occurs directly within the kidneys due to damage to the nephrons
    • Post-renal occurs downstream of the kidneys due to obstruction of urine flow, leading to a build-up of pressure in the kidneys and damage to the nephrons.
    • The body breaks down fat for energy, producing ketones, causing metabolic acidosis, dehydration, and electrolyte imbalances.

    ### Glomerulonephritis

    • Acute glomerulonephritis: Structural and functional changes; cellular proliferation leads to an increase in the number of cells in the glomerular tuft due to proliferation of endothelial, mesangial, and epithelial cells.
    • Nephrotic syndrome: Inflammation of the glomerulus caused by primary glomerular injury exacerbated by immunologic responses, drugs, toxins, and infections, resulting in type III hypersensitivity reactions, antibodies, and inflammation.

    Microvascular Complications of Diabetes Mellitus

    • Result from prolonged hyperglycemia and primarily affect small blood vessels, leading to significant morbidity.
    • The three main types are: - Diabetic Retinopathy: Damage to retinal blood vessels, causing symptoms like blurred vision and floaters, potentially leading to vision loss.
      • Diabetic Nephropathy: Kidney damage that starts with microalbuminuria and can progress to proteinuria and end-stage renal disease.
      • Diabetic Neuropathy: Affects peripheral and autonomic nervous systems, leading to numbness, tingling, pain, and gastrointestinal and cardiovascular issues.

    ### Investigations of Patients with Diabetes Mellitus

    • Eye exams: Fundoscopy to assess retinal health.
    • Urine tests: For albumin and creatinine to assess kidney function.
    • Nerve conduction studies: To assess nerve function.
    • Blood glucose testing: To monitor blood sugar levels.
    • Haemoglobin A1c (HbA1c) levels: To measure long-term blood sugar control.

    Management of Diabetes Mellitus

    • Maintaining tight glycemic control, along with managing blood pressure and lipid levels, is essential to prevent or slow progression of complications.
    • Regular screening and early management are key to reducing the burden of these complications.

    Chronic Kidney Disease (CKD)

    • CKD is a progressive loss of kidney function that eventually requires renal replacement therapy like dialysis or transplantation.
    • Common causes:
      • Type 2 Diabetes Mellitus
      • Type 1 Diabetes Mellitus
      • Hypertension
      • Primary Glomerulonephritis
      • Chronic Tubulointerstitial Nephritis
      • Hereditary or cystic diseases
      • Secondary glomerulonephritis or vasculitis
      • Neoplasm
    • CKD can be caused by factors that affect renal perfusion pressure (prerenal), intrinsic renal structures (vessels, glomeruli, tubules), or postrenal obstruction.
    • The progression of CKD leads to kidney fibrosis, destruction of normal kidney architecture, and uraemic symptoms.
    • Stages of CKD progression:
      • Infiltration of damaged kidneys with extrinsic inflammatory cells
      • Activation, proliferation, and loss of intrinsic renal cells (through apoptosis, necrosis, mesangiolysis, and podocytopenia)
      • Activation and proliferation of extracellular matrix (ECM) producing cells including myofibroblasts and fibroblasts
      • Deposition of ECM replacing the normal architecture

    CKD Signs and Symptoms

    • Nausea
    • Vomiting
    • Loss of appetite
    • Fatigue and weakness
    • Sleep disturbance
    • Oliguria
    • Decreased mental sharpness
    • Muscle twitches and cramps
    • Swelling of feet and ankles
    • Persistent pruritus (itchiness)
    • Chest pain due to uremic pericarditis
    • Shortness of breath due to pulmonary oedema from fluid overload
    • Hypertension that is difficult to control

    CKD Treatment

    • Treatment options:
      • Haemodialysis
      • Peritoneal dialysis (continuous or intermittent)
      • Kidney transplantation (living or deceased donor) - preferred choice for ESRD due to better long-term outcomes.
      • Conservative and palliative care management for patients who decline renal replacement therapy.

    CKD Nursing Management

    • Monitor fluid and electrolyte imbalances:

      • Monitor serum electrolyte levels and physical indicators
      • Monitor for excessive potassium intake
      • Monitor cardiac and musculoskeletal status
      • Record input and output
      • Observe for oedema, jugular vein distention, changes in heart and breath sounds, and breathing difficulties
      • Obtain an accurate daily weight

    • Reduce metabolic rate:

      • Helps to reduce catabolism and subsequent release of potassium and accumulation of endogenous waste products (urea & Creatinine).

    • Prevent infection:

      • Practice asepsis with nursing care
      • Avoid invasive devices such as indwelling catheters

    • Provide skin care:

      • Skin may be dry or susceptible to breakdown due to oedema, excoriation, and irritation from uraemia.
      • Provide pressure area care (PAC) and good skin hygiene.

    • Psychological support:

      • Provide education, information, and support to the patient and their family.

    Acute Kidney Injury (AKI)

    • AKI is associated with a sudden drop in glomerular filtration rate (GFR).
    • Clinical diagnosis of AKI:
      • Blood tests for full blood count (FBC), urea and electrolytes (U&Es), and renal function.
      • Urinalysis
    • RIFLE classification system:
      • Widely used to classify AKI based on serum creatinine levels, GFR, and urine output.

    AKI Treatment

    • The treatment plan should be tailored to the type of AKI and causative agents.

    • Prerenal AKI:

      • Correct fluid volume deficits
      • Improve heart failure using inotropic agents

    • Intrarenal AKI:

      • Manage the cause of kidney damage
      • Eliminate nephrotoxic agents

    • Postrenal AKI:

      • Manage the cause of obstruction

    • AKI recovery:

      • After removing the cause of the injury, repair can begin and renal function can start to recover.
      • However, it can take months for normal kidney function to be restored, and full recovery may not be possible.

    Urinary System Overview

    • The ureters carry urine from the kidneys to the bladder via peristaltic waves.
    • The urethra originates from the bladder base and extends through the penis (males) or opens anterior to the vagina (females).
    • The bladder is controlled by both internal (involuntary smooth muscle) and external (voluntary smooth muscle) sphincters.

    Renal Function Tests

    • Renal function tests assess kidney health through factors such as:
      • Blood urea nitrogen (BUN)
      • Creatinine
      • Estimated glomerular filtration rate (eGFR)
      • Urine albumin excretion

    Micturition

    • Micturition, or urination, involves urine excretion from the bladder.
    • The bladder acts as a reservoir, with rugae (folds) expanding as it fills, maintaining consistent intravesicular pressure.
    • Stretch receptors in the bladder wall trigger the micturition reflex when the bladder is full.
    • This reflex causes the detrusor muscle to contract, simultaneously relaxing the internal urethral sphincter, allowing urine flow into the urethra.

    Kidneys

    • The kidneys, located retroperitoneally in the abdomen, play a key role in maintaining homeostasis.
    • They regulate fluid and electrolyte balance and eliminate waste products.
    • The kidneys produce various hormones, including erythropoietin, renin, and cortisol, which influence red blood cell production, blood pressure, and sodium retention.

    Urinary Tract Infections (UTIs)

    • The urinary tract is sterile, protected by urine flushing, IgA secretions, and the presence of resident microbes in the distal urethra.
    • UTIs commonly originate from bacterial contamination during urination, ascending from the urethra to the bladder and potentially the kidneys.
    • Symptoms of lower UTI include frequent urination, urgency, dysuria, suprapubic pain, and cloudy or foul-smelling urine.
    • Fever and back pain can indicate ascending infection or pyelonephritis.
    • Symptoms of upper UTI include fever, chills, flank pain, tachycardia, and potential sepsis.

    UTI Diagnosis

    • Urine samples are collected for analysis, observing color, odor, and turbidity.
    • Dipstick tests detect:
      • Neutrophils (pyuria)
      • High bacterial concentration
      • Nitrites (bacterial metabolism)
      • Blood (haematuria)
    • Urine culture and sensitivities determine the causative pathogen and its antibiotic sensitivity.
    • Blood tests may reveal increased white blood cells (leucocytosis) and elevated neutrophils (neutrophilia) in cases of sepsis.

    Chronic Kidney Disease (CKD)

    • Characterized by progressive deterioration of kidney function over time.
    • Progression leads to complications such as:
      • Nausea, vomiting, loss of appetite
      • Fatigue, weakness, sleep disturbances
      • Oliguria (decreased urine output)
      • Decreased mental sharpness
      • Muscle twitches and cramps
      • Swelling in feet and ankles
      • Skin pigmentation
      • Uremic frost (urea in sweat)
      • Uremic breath

    CKD Treatment

    • Options for renal replacement therapy include:
      • Haemodialysis
      • Peritoneal dialysis (continuous or intermittent)
      • Kidney transplantation
    • Conservative and palliative care is offered for patients declining renal replacement therapy.
    • Haemodialysis requires suitable vascular access, often an arteriovenous (AV) fistula for optimal patency and reduced infection risk.

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    Description

    This quiz delves into Type 1 Diabetes Mellitus, focusing on its symptoms, diagnosis, and the severe complication of Diabetic Ketoacidosis (DKA). Learn about key indicators such as blood glucose levels, symptoms of insulin deficiency, and the importance of timely management. Gain insights into the autoimmune aspects and testing methods for effective diagnosis.

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