A 60-year-old patient complains of thirst, frequent urination, dry mouth, tingling sensation, chilly feet, and a...

A 60-year-old patient complains of thirst, frequent urination, dry mouth, tingling sensation, chilly feet, and a feeling of heaviness in the right lower leg for a long time. He has been suffering from diabetes for about 10 years. For 4 years, he notes the appearance of pain in the right leg when walking. Height 170 cm, weight 120 kg, with a predominant deposition of adipose tissue in the waist area. On the right leg: the foot has normal temperature, the pulse on the artery is palpable, there is a slight swelling in the lower leg, the veins are deformed, the skin is bluish-brown, there is a painless ulceration of the skin 1 cm in diameter. On the left foot: the foot is slightly cooler than the contralateral foot, the pulse on the artery is not palpable. Labs: Blood: Sugar 13 mmol / I, cholesterol 7.5 mmol/l Urine: protein 0.1 g/I, sugar 2%, acetone (-). 1. what is the reason for the patient's complaints of tingling and chilly feet? What is the mechanism? 2. what are the typical disorders of peripheral blood circulation observed on the left leg? What is the for them? 3. What types of chronic diabetes complications are observed in the patient? What organs or systems are affected? Explain the mechanism of development.

Expert Solution

(continue) The pehripheral nerve of the patient will get narrow and ultimately will block and will cause peripheral artery disease causing less blood supply leading to numbness,tingling etc. It can also on long run cause recurrent infections on foot and the patient might go unnoticed because of sensation loss ultimately leading to foot ulcer. And also cause many skin infections like ancanthosis nigricans leading to sever pigmentation etc. ON THE CVS,it can cause atherosclerosis leading to low blood supply to the heart causing Myocardial infarction and also gangrene of the lower extremities. AND ALSO because low blood supply to kidney, it can cause kidney failure and all the lesions of kidney are collectively called DIABETIC NEPHROPATHY.

Nightingale answered 3 years ago

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