Neuropathy Autonomic Neuropathy 1 — Questions and Answers
Question 1: Which gastrointestinal manifestation is most common in diabetic autonomic neuropathy?
- Acute pancreatitis
- Gastroparesis (Correct answer)
- Ulcerative colitis
- Esophageal varices
Correct answer: Gastroparesis
Gastroparesis, delayed gastric emptying due to vagal nerve dysfunction, is the most common GI manifestation of diabetic autonomic neuropathy.
Question 2: Orthostatic hypotension in autonomic neuropathy is defined as a systolic blood pressure drop of at least how many mmHg upon standing?
- 10 mmHg
- 20 mmHg (Correct answer)
- 30 mmHg
- 40 mmHg
Correct answer: 20 mmHg
Orthostatic hypotension is defined as a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing.
Question 3: Cardiac autonomic neuropathy (CAN) is associated with which serious cardiac risk?
- Aortic stenosis
- Sudden cardiac death due to arrhythmia (Correct answer)
- Pericardial effusion
- Mitral valve prolapse
Correct answer: Sudden cardiac death due to arrhythmia
CAN is associated with a significantly increased risk of sudden cardiac death due to QT prolongation and cardiac arrhythmias.
Question 4: Anhidrosis (inability to sweat) from autonomic neuropathy most commonly begins in which body region?
- Face and scalp
- Upper trunk
- Feet and legs (ascending pattern) (Correct answer)
- Hands and arms
Correct answer: Feet and legs (ascending pattern)
Autonomic neuropathy-related anhidrosis typically begins in the distal lower extremities and ascends, mirroring the length-dependent nerve damage.
Question 5: Which bedside test is used to evaluate cardiovagal autonomic function in cardiac autonomic neuropathy?
- Tilt table test
- Heart rate variability with deep breathing (E:I ratio) (Correct answer)
- Quantitative sudomotor axon reflex test
- Thermoregulatory sweat test
Correct answer: Heart rate variability with deep breathing (E:I ratio)
The heart rate response to deep breathing (E:I ratio) is a sensitive, non-invasive test of parasympathetic cardiac function.
Question 6: Which symptom is a hallmark of genitourinary autonomic neuropathy in male diabetic patients?
- Testicular pain
- Erectile dysfunction
- Urinary retention and overflow incontinence
- Both erectile dysfunction and urinary dysfunction (Correct answer)
Correct answer: Both erectile dysfunction and urinary dysfunction
Genitourinary autonomic neuropathy in men causes both erectile dysfunction (parasympathetic) and bladder dysfunction with overflow incontinence.
Neuropathy Autonomic Neuropathy 1
Which gastrointestinal manifestation is most common in diabetic autonomic neuropathy?