Archive:Diabetic history

Type and Duration

• Type1DM or Type2DM?
• AGE of onset
• MANNER of diagnosis (symptoms, routine labs)

Glucose Control

• FREQUENCY of monitoring
• VALUES - usual numbers at AM and PM, taken AC or PC, range, HbA1c

• HYPOGLYCEMIC episodes
  • frequency
  • severity
  • sympathetic prodrome
  • unheralded neuroglycopenic symptoms
    • hunger, dizziness, tingling, blurred vision, difficulty thinking, and faintness

Diet and Exercise (CDA)

• quantity (calories)
• quality

Medications

• oral hypoglycemics
• insulin (type, units, timing)
• antagonistic drugs (thiazides, corticosteroids)

Modifiable Risk Factors

• Hypertension
• Hypercholesterolemia
• Smoking
• Alcohol

PMHx

• Stroke
• MI

ROS

Neuropathy

• Autonomic:
  • Erectile dysfunction
  • orthostatic hypotension
  • gastroparesis
  • constipation

• Peripheral:
  • anesthesia
  • paresthesia
  • hyperesthesia

Retinopathy

• date of last eye exam with an OPHTHALMOLOGIST (MD)

Nephropathy

• renal disease
• proteinuria or microalbuminuria
• last URINE ANALYSIS
• last serum creatine

Vascular

Cardiac

• angina
• dyspnea
• orthopnea
• CHF
• MI

Peripheral Vascular Disease

• claudication
• foot care

Hospitalization

• Hypoglycemia
• DKA
• HONKS (hyperosmolar nonketotic state)

Other OSCE Modules

Observed structured clinical examination

Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence