Huda Hamouda 09090116 3rd year MBBS

Orthopedics

foot ulcer
* A skin ulcer is caused by an injury to skin that has poor blood supply. * more common in the elderly and in those with diabetes. * Symptoms that may occur with a skin ulcer include pain, redness, swelling , tenderness around the ulcer, fever, bleeding, or pus draining from the ulcer.

cellulitis
* A person with cellulitis has an infection of the superficial and deep layers of the skin, caused by bacteria (streptoccocal and staphylococcal) * Symptoms of cellulitis depends on the location of the infection. skin redness and skin swelling, tenderness, and warmth ,fever and nausea.

Gangrene
* reduced sensation in the feet ulcer reduced blood supply the ulcer become infected restrict the blood supply further gangrene * It is only possible to stop severe cases of gangrene from spreading by amputating the foot. * People with diabetes are 15 times more likely to have an amputation due to gangrene than people who do not have diabetes.

Cardiovascular autonomic neuropathy

* CAN occurs when damage to the peripheral nerves disrupts the automatic functions that control the blood circulation and heartbeat. * CAN is estimated to occur in 5-10% of people who have had diabetes for 20 years or more. The two main noticeable symptoms of CAN are: 1) an inability to exercise for more than a very short period of time 2) orthostatic hypotension * A more serious concern with CAN is that the heart may suddenly experience an abnormal pattern of beating (arrhythmia), which could lead to a cardiac arrest

Orthostatic hypotension
* A type of low blood pressure that develops when you move from a sitting or lying position to a standing position. * It occurs because the problems caused by CAN mean that your circulatory system can longer compensate for the effects of gravity when you move to an upright position. * This means that the top half of your body, in particular your brain, can become starved of blood. This causes symptoms such as: ( dizziness / nausea / headache / vision problems / mental confusion / fainting )

Life threatening complications

* Some complications of peripheral neuropathy can be life threatening . * If pt has chest pain, difficulty breathing, or a change in alertness or passing out.