Male, 44 years old, began to experience heat physiotherapy(once a day) in a bio technology company on April 26th. From May 15th to May 17th , swelling, blisters and ulcers appeared in his left upper limb. On May 18th , he died. The autopsy showed that the left upper limb was extremely swollen and dark red. Diffused neutrophil infiltration under the skin and muscle, accompanied by soft tissue necrosis were detected by microscopic examination. And diffused glomerular fibrosis and hyaline degeneration were detected, which can be diagnosed as Diabetic Neuropathy(late stage).
Questions:
Please make a pathological diagnosis of the lesion of his left upper limb.
Please discuss the outcome(improvement or deterioration) of acute inflammation and its influencing factors.
As a clinician, how do you diagnose and treat Diabetic neuropathy?
Please try to analyse the impact of diabetic neuropathy(late stage) on the prognosis of this patient.
Answers
Answer:
A doctor can usually diagnose diabetic neuropathy by performing a physical exam and carefully reviewing your symptoms and medical history. Your doctor will check your: Overall muscle strength and tone. Tendon reflexes.
This type of neuropathy (nerve injury) usually develops in stages. First one may experience intermittent pain and tingling in extremities, particularly in the feet. In later stages, the pain is more intense and constant. In the last stage, all pain sensation is lost to an area.
Nerve damage (peripheral neuropathy) often results and problems to the structure of the foot can also occur – for example, clawed toes. Reduced blood supply and nerve function can delay healing, increase the risk of infection, reduce feeling in the feet, and lead to ulcers and structural foot problems.
