CFCN
Final Test Review
(Questions & Solutions)
2025
1
,1. Case: A 65-year-old man with type 2 diabetes presents with a 1.5 cm
plantar ulcer beneath the first metatarsal head. He has a 5-second
positive 10 g monofilament test and a 3 mm callus rim. What is your next
priority?
A. Prescribe topical antibiotic
B. Debride hyperkeratosis and offload pressure
C. Order MRI for osteomyelitis
D. Initiate systemic antifungal therapy
ANS: B
Rationale: Callus debridement and offloading redistribute plantar
pressure, a prerequisite for ulcer healing.
2. Case: A 70-year-old woman with nonhealing toe ulcer has an ABI of
0.68. Transcutaneous O₂ tension (TCOM) at the forefoot is 18 mmHg.
What do these findings suggest?
A. Adequate perfusion for healing
B. Critical ischemia; refer for revascularization
C. False-high ABI from calcification
D. Vasospasm; start calcium channel blocker
ANS: B
Rationale: ABI <0.7 and TCOM <20 mmHg indicate insufficient perfusion;
revascularization is indicated.
3. Case: A 58-year-old patient with chronic venous insufficiency has foot
edema, hemosiderin staining, and superficial excoriations. Which
intervention best addresses skin integrity?
A. Ionic silver dressing
B. Graduated compression stocking (30–40 mmHg)
C. Topical corticosteroid ointment
D. Daily talcum powder application
ANS: B
Rationale: Medical-grade compression reduces edema, improves venous
return, and prevents dermatitis.
2
, 4. A 60-year-old diabetic reports numbness in toes. Monofilament exam:
cannot feel 10 g at hallux, can feel at dorsum. Which statement is
correct?
A. Large-fiber neuropathy is unlikely
B. Protective sensation is lost; high ulcer risk
C. ABI should be >1.3 for accurate result
D. Sensory neuropathy is only in small fibers
ANS: B
Rationale: Loss of 10 g sensation at the hallux denotes loss of protective
sensation and ulcer risk.
5. Case: A patient with rheumatoid arthritis develops painful hammer
toes and calluses beneath PIP joints. What is the most effective non-
surgical intervention?
A. Metatarsal pad insole
B. Custom total contact cast
C. Night-time pharmacopuncture
D. Topical capsaicin cream
ANS: A
Rationale: Metatarsal pads offload pressure under metatarsal heads and
PIP joints, reducing callus formation and pain.
6. Case: Early (Stage 0) Charcot foot presents with swelling, erythema,
and temperature difference >3 °C but normal X-ray. Best initial
management:
A. Weight-bearing ankle orthosis
B. Total contact cast and non–weight-bearing
C. IV bisphosphonate therapy
D. MRI to rule out abscess
ANS: B
Rationale: Acute Charcot requires strict offloading with a total contact
cast to prevent progression.
7. A 45-year-old athlete presents with interdigital maceration, pruritus,
3
Final Test Review
(Questions & Solutions)
2025
1
,1. Case: A 65-year-old man with type 2 diabetes presents with a 1.5 cm
plantar ulcer beneath the first metatarsal head. He has a 5-second
positive 10 g monofilament test and a 3 mm callus rim. What is your next
priority?
A. Prescribe topical antibiotic
B. Debride hyperkeratosis and offload pressure
C. Order MRI for osteomyelitis
D. Initiate systemic antifungal therapy
ANS: B
Rationale: Callus debridement and offloading redistribute plantar
pressure, a prerequisite for ulcer healing.
2. Case: A 70-year-old woman with nonhealing toe ulcer has an ABI of
0.68. Transcutaneous O₂ tension (TCOM) at the forefoot is 18 mmHg.
What do these findings suggest?
A. Adequate perfusion for healing
B. Critical ischemia; refer for revascularization
C. False-high ABI from calcification
D. Vasospasm; start calcium channel blocker
ANS: B
Rationale: ABI <0.7 and TCOM <20 mmHg indicate insufficient perfusion;
revascularization is indicated.
3. Case: A 58-year-old patient with chronic venous insufficiency has foot
edema, hemosiderin staining, and superficial excoriations. Which
intervention best addresses skin integrity?
A. Ionic silver dressing
B. Graduated compression stocking (30–40 mmHg)
C. Topical corticosteroid ointment
D. Daily talcum powder application
ANS: B
Rationale: Medical-grade compression reduces edema, improves venous
return, and prevents dermatitis.
2
, 4. A 60-year-old diabetic reports numbness in toes. Monofilament exam:
cannot feel 10 g at hallux, can feel at dorsum. Which statement is
correct?
A. Large-fiber neuropathy is unlikely
B. Protective sensation is lost; high ulcer risk
C. ABI should be >1.3 for accurate result
D. Sensory neuropathy is only in small fibers
ANS: B
Rationale: Loss of 10 g sensation at the hallux denotes loss of protective
sensation and ulcer risk.
5. Case: A patient with rheumatoid arthritis develops painful hammer
toes and calluses beneath PIP joints. What is the most effective non-
surgical intervention?
A. Metatarsal pad insole
B. Custom total contact cast
C. Night-time pharmacopuncture
D. Topical capsaicin cream
ANS: A
Rationale: Metatarsal pads offload pressure under metatarsal heads and
PIP joints, reducing callus formation and pain.
6. Case: Early (Stage 0) Charcot foot presents with swelling, erythema,
and temperature difference >3 °C but normal X-ray. Best initial
management:
A. Weight-bearing ankle orthosis
B. Total contact cast and non–weight-bearing
C. IV bisphosphonate therapy
D. MRI to rule out abscess
ANS: B
Rationale: Acute Charcot requires strict offloading with a total contact
cast to prevent progression.
7. A 45-year-old athlete presents with interdigital maceration, pruritus,
3
