西安交通大学医学院内分泌系统疾病课件 Pathophysiology.pptVIP

Pathophysiology 1. carbohydrate: glycogenesis , glycogenolysis 2. fat : free acid , TG , 3. protein: negative nitrogen balance, 4. ketoacidosis, 5. plasma hyperosmolarity. Clinical presentations 1. Symptoms of metabolic orders: polyuria, polydipsia, polyphagia, loss of weight 2. Acute complications:DKA,HHS 3. Chronic complications: (1) Macrovascular complications (coronary artery disease;peripheral vascular disease; cerebrovascular disease) (2) Microvascular complications (Retinopathy; Nephropathy; Nephropathy) (3) Nonvascular complications (dermatologic;infectious;cataracts;glaucoma) Microvascular complications 1. Eye disease Retinopathy nonproliferative (retinal vascular microaneurysms, blot hemorrhages, and cotton wool spots) proliferative (neovascularization) 2. Neuropathy Sensory Motor Autonomic 3. Nephropathy,5 stages stage 1: GFR , increase in size of kidney; Stage 2: intermittent microalbuminuria; stage 3: permanent microalbuminuria (30-300mg/d); stage 4: proteinuria, edema,hypertension; stage 5: BUN, Cr c. Neuropathy: (a) Peripheral polyneuropathy: Hyperesthesia, paresthesia, and dysesthesia, sensory loss. Symptoms: numbness, tingling, sharpness, burning,or pain Physical examination: sensory loss, loss of ankle reflexes, and abnormal position sense. (b) Mononeuropathy: the 3nd cranial nerve( diplopia,ptosis and opthalmoplegia) (c) Radiculopathy: disabling pain over the thorax or abdomen(Intercostal or truncal); in the thigh or hip(lumbar plexus or femoral nerve) (d) Autonomic neuropathy: Cardiovascular system: resting tachycardia; orthostatic hypotension; su