eH hsa alecf eneninoincct so ish elrtnxea pterincsh si agdmd,ea ihhcw is danvtereni yb het plaenddu n. ().2SS-4 hTe clviep lhpiacsnnc erev,sn hiwhc imedeta hte nceietor orses,cp aer slao SS24.-
,,2S43 eskep het 3 'Ps fof eth lorfo sn(i,eP ooP, dna Pe)e
I took the approach of 10 year history DM --> Chronic DM complications = 1. Nonenzymatic Glycosylation (NEG) 2. Osmotic Damage.
Osmotic Damage can lead to neuropathy and autonomic degeneration. Fecal incontinence can be indicative of autonomic damage (parasympathetics = rest + digest = poop; There was a UWorld Q about constipation + parasympathetics - can't remember ID Sorry).
A. Dysuria --> Not related to NEG or osmotic damage
C. Inability to climb stairs --> Motor > sensory, so unlikely NEG or osmotic
D. Night-time leg cramps --> Claudication/PAD can present with symptoms that are worse at night when legs are horizontal with height, however this isn't cramping pain, which hints to an MSK problem or RLS.
E - Sciatica --> Not related to NEG or Osmotic Damage.
That leaves us with B --> Erections are obtained by pointing, shooting, and squeezing (parasympathetics, sympathetics, somatic). Impotence specifically is failure to obtain erection = failure to point = failure of parasympathetics = autonomic instability secondary to osmotic damage
Reference = FA2018 - page 344