please send the answers via my email . mercyozim@yahoo.com thanks pathy. Explain

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please send the answers via my email . mercyozim@yahoo.com
thanks

pathy. Explain how retinopathy impairs vision teHorated in the last 3 years because 9 Describe two problems related to diabetes that Mr. M. might encounter because of his reduced vision CASE STUDY B Diabetes Mellitus Type 2 At that time, he bo r. F. was diagnosed with Type 2 diabetes mellitus at age 46. was overweight, enjoyed foods with high car hydrate and fat content, and led a sedentary life. His family history indicated that his mother and his brother had diabetes. Weight loss, appropriate diet, and exercise were recommended to reduce blood glucose levels. I. List the factors contributing to diabetes mellitus in this At age 50, Mr. F. noticed that his vision was cloudy. particularly in one eye. Cataracts were removed from b case. eyes Describe a cataract and explain how diabetes promotes cataract formation. 2. 3. Glyburide (DiaBeta) was prescribed at this time. Describe the action of this drug At age 56, a blister developed on the heel of one foot, which did not heal. An ulcer formed and persisted. Finally the foot was placed in a cast for 13 weeks to promote healing. 4. Explain several factors contributing to the delayed healing in Mr. F. 5. Why was it necessary in this case, to remove the cast and replace it each week? Peripheral neuropathy with total loss of sensory function had developed in both feet. Motor function was not directly affected. Orthopedic shoes were ordered and arrangements made for a podiatrist to provide regular foot care.

Explanation / Answer

Ans 1. In Mr. F case who is diagonised with Type 2 diabetes mellitus , the factors are:
i) he developed insulin resistance due to intake of high calorie food
ii) As he is above 40 , his body is not producing significant amount of insulin

iii) his cells have developed a resistance to insulin

iv) His body cannot store excess glucose in form of glucagon

2 Ans: Cataract is the clouding of lens which results in decrease in vision.
Due diabetes mellitus excess glucose cannot be converted into glycogen hence it deposits in various organs such as lens of the eye.

3 Ans Gluburide is a type 2 anti diabetic drug which inhibits ATP sensitive potassium channels and causes inhibitory regulatory action by subunit sulfonylurea in beta cells of pancreas . this causes cell membrane depolarization opening voltage dependent calcium channels. The increase in calcium concentration in beta cells stimulates secretion of insulin. the insulin then converts excess glucose to glycogen.

4.Ans high blood glucose in Mr F 's blood affect the nevers and also causes hinderance in blood circulation. Blood doesnot circulate properly due to narrowing of blood vessels by deposition of glucose in them. Hence in case of wounds it does not get proper blood (leucocytes) to fight pathogens and platelets to close wound hence causing higher chance of infections.

5.ans. As a diabetic person like mr f is prone to infections due to lack of proper blood circulation, it is necessary to remove and sanitize the wound and place a new cast.

6. Ans. As the wound doesnot receive proper leucocytes to fight germs it is necessary to clean the wound at regular intervals to prevent gangrene due lack to blood ( oxygen,nutrients,leucocytes).

7 Ans. Symptoms of hyper tension are headaches, dizziness, buzzing of ears altered vision etc.

8Ans Fonsinopril is a agiotensin converting enzyme inhibiter used for treating hypertension. Atorvastatin or lipitor is a lipid lowering agent which prevents cardiovascular agent by stopping cholesterol deposition in blood vessels. Amlodipine treats high blood pressure and coronary artery diseases. Warfarin is an anticoagulant which prevents clotting of blood which is common in case of cholesterol deposition in blood vessels. Sotalol is used to treat abnormal heart rythims.

9 Ans . Hb A1c means glycated haemoglobin. It is when haemoglobin of RBCs combine with glucose of blood plasma. Normal level is 4%.

10. Ans. bruising is cause to blood clotting easily due to hypertension ( rupturing of capillaries). It is advised to lover the blood cholesterol by exercise and healthy diet and in severe cases a blood thinner or anticoagulant is recommended.

11. If type 2 diabetes is kept untreated there would be following consequences :

i) Heart and blood diseae

ii) Eye disease leading to blindness
iii) nerve damage

iv) hearing impairment

v) kidney failure ( due to deposition of glucose in nephrons

vi) Alzeimer's disease.

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