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Flashcards in Diabetic Foot Care Deck (15)
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1
Q

what are the principle pathogenic mechanisms of diabetic foot facts?

A
  • neuropathy(reduced pain and proprioception, reduced joint mobility)
  • PVD (foot ischemia)
  • infection
  • -a combinnation of these things lead to foot ulceration.
2
Q

What is the answer to preventing all diabetes complications?

A

-TIGHT glycemic control

3
Q

Sx of:

  • sensory neuropathy
  • motor neuropathy
  • autonomic neuropathy
A
  • Sensory: nerve damage, numbness, burning, tingling, pins and needles.
  • Motor: nerve damage leading to musculoskeletal deformities
  • Autonomic: nerve damage leading to dry feet, feet dont sweat, cracking of feet.
4
Q

How does PVD decrease the body’s ability to fight infection and to heal wounds in the foot?

A

-lack of blood flow and oxygen to the area from ischemia

5
Q

What are some common nail deformities

A
  • onychomycosis (fungus)
  • onychocryptosis (ingrown toenail)
  • subungual ulceration
6
Q

What are some sensory tests used to evaluate the diabetic foot?

A
  • Weinstein monofilament
  • significant neuropathy if unable to feel greater than 6 sites

-vibratory exam (tuning fork)

7
Q

How do we test the vascular system in the foot?

A
  • paplation of foot pulses
  • capillary refill testing
  • doppler testing
  • edematous changes
8
Q

What are some signs of arterial disease?

A
  • intermittent claudication
  • thin, shiny skin with lack of hair
  • lack of subQ padding
  • dusky/red/cyanotic/grey color
9
Q

What are some musculoskeletal deformities of the foot?

A
  • high arch (Pes Cavus)
  • no arch (pes planus)
  • Bunions
  • Claw and hammer toes
  • past ulceration sites
  • charcot foot
10
Q

Cellulitis:

  • most commonly caused by what bacteria?
  • treatment
A

-caused by strep A and B, also Staph aureus

  • tx: cephalosporins, clindamycin
  • debridment and flushing
  • offloading
  • dressing changes
11
Q

Acute osteomyelitis

  • what is this?
  • what is the usual bacterial cause?
  • Tx
A
  • infection down to the bone
  • S. Aureus
  • Tx:
  • abx therapy
  • debridement
  • infectious disease consult
12
Q

Charcot Foot

-what is this?

A

-destructive arthropathy resulting from impaired pain perception and increased bone blood flow. Bone becomes washed out and weak resulting in small periarticular fx until joints become destroyed

13
Q

Signs of Charcot Foot

  • most common causes
  • tx
A
  • Signs: painless swelling and bounding pulses
  • cause: diabetes and other conditions causing neuropathy
  • tx: immobilization
14
Q

Diabetic Foot Risk Classification signs of:

  • low current risk
  • increased risk
  • high risk
  • ulcerated foot/foot care emergency
A
  • Low” normal sensation, pulses palpable
  • increased: neuropathy or absent pulses
  • high: neuropathy or absent pulses plus other risk factors
  • ulcerated: ulcer present or sign of infection/charcot foot development
15
Q

General Tx of Diabetic Feet

A
  • buy proper shoes, no narrow box toes
  • good foot care, always be checking the feet for sores
  • tight glycemic control
  • if ulcer: possible abx, possible x-ray to confirm no bone involvment, non-weight bearing on foot with ulcer
  • some may require amputation.