Podiatry - Clinical Exam Questions With Complete
Solutions
Acute gout Correct Answers Usually monoarticular - affecting
the 1st MPJ
- joint can become red, hot and swollen
- max intensity 8-12 hours
- Increased WBC
- only way to determine it isn't septic
Autolytic debridement Correct Answers liquefaction, separation
and digestion of necrotic tissue & eschar from healthy tissue
Chronic Gout Correct Answers recurrent attacks may prevent
complete recovery of the joint between attacks, gradually
leading to the development of crippling, destructive arthritis.
- can mimic RA
Controlling oedema - and exudate management Correct Answers
- important for the management of lower limb venous
ulcerations
- linked to ulcer healing rates
- oedema control - compression bandaging, hosiery, massage,
intermittent pneumatic compression
Define Autonomic Neuropathy - how does it effect the lower
limb? Correct Answers - Autonomic dysfunction characterised
by a decrease in sensation & function from impulses from CNS
to organs
,Effects involuntary body functions, including heart rate, blood
pressure, perspiration & digestion
- This damage disrupts signals between the brain and portions of
the ANS
- Causes sudomotor dysfunction - anhidrosis
- Orthostatic hypotension
- Tachycardia
Define critical limb Ischaemia Correct Answers 1) CLI
represents the end stage of PAD
2) Is where peripheral flow is reduced to the point at which the
patient has chronic ischaemic rest pain, or ischaemic skin lesions
Define Gout Correct Answers Gout is a common form of
arthritis, characterised by hyperuricaemia and uric acid crystal
formation
Define gout Correct Answers is a group of conditions
characterised by hyperuricaemia & uric acid crystal formation.
Define IC - intermittent claudication Correct Answers Is
transient ischaemic muscle pain that occurs during exercise.
IC is a strong clinical indicator of the presence of significant
PAD
Define PAD - Peripheral arterial disease Correct Answers
Comprises those entities which result in obstruction to blood
flow in the arteries
, define Poly-sorbitol pathway Correct Answers - Glucose is
changed to sorbitol by the action of aldose reductase
- Aldose reductase competes with nitric oxide which causes
vasoconstriction of endoneural capillaries and nerve hypoxia
- This will ultimately lead to nerve ischemia.
- Sorbitol can also accumulate in the neurones and supporting
kisses - this has an osmotic effect & leads to water moving into
neural tissue
- This causes neural and perineural oedema and causes
demyelination of schwann cells, leading to the reduction of
nerve transmission
Define Rest pain Correct Answers Rest pain is persistent pain
caused by nerve ischaemia leading to ischaemic neuropathy
Define telangiectasia Correct Answers Telangiectasia are
permanent dilation of blood vessels
Define type 1 diabetes Correct Answers - The pancreas
produces little to no insulin and without it the body cannot turn
glucose into energy
- Without insulin the body burns its own fats as substitutes -
needs to be treated with daily injections of insulin (insulin
dependant)
Solutions
Acute gout Correct Answers Usually monoarticular - affecting
the 1st MPJ
- joint can become red, hot and swollen
- max intensity 8-12 hours
- Increased WBC
- only way to determine it isn't septic
Autolytic debridement Correct Answers liquefaction, separation
and digestion of necrotic tissue & eschar from healthy tissue
Chronic Gout Correct Answers recurrent attacks may prevent
complete recovery of the joint between attacks, gradually
leading to the development of crippling, destructive arthritis.
- can mimic RA
Controlling oedema - and exudate management Correct Answers
- important for the management of lower limb venous
ulcerations
- linked to ulcer healing rates
- oedema control - compression bandaging, hosiery, massage,
intermittent pneumatic compression
Define Autonomic Neuropathy - how does it effect the lower
limb? Correct Answers - Autonomic dysfunction characterised
by a decrease in sensation & function from impulses from CNS
to organs
,Effects involuntary body functions, including heart rate, blood
pressure, perspiration & digestion
- This damage disrupts signals between the brain and portions of
the ANS
- Causes sudomotor dysfunction - anhidrosis
- Orthostatic hypotension
- Tachycardia
Define critical limb Ischaemia Correct Answers 1) CLI
represents the end stage of PAD
2) Is where peripheral flow is reduced to the point at which the
patient has chronic ischaemic rest pain, or ischaemic skin lesions
Define Gout Correct Answers Gout is a common form of
arthritis, characterised by hyperuricaemia and uric acid crystal
formation
Define gout Correct Answers is a group of conditions
characterised by hyperuricaemia & uric acid crystal formation.
Define IC - intermittent claudication Correct Answers Is
transient ischaemic muscle pain that occurs during exercise.
IC is a strong clinical indicator of the presence of significant
PAD
Define PAD - Peripheral arterial disease Correct Answers
Comprises those entities which result in obstruction to blood
flow in the arteries
, define Poly-sorbitol pathway Correct Answers - Glucose is
changed to sorbitol by the action of aldose reductase
- Aldose reductase competes with nitric oxide which causes
vasoconstriction of endoneural capillaries and nerve hypoxia
- This will ultimately lead to nerve ischemia.
- Sorbitol can also accumulate in the neurones and supporting
kisses - this has an osmotic effect & leads to water moving into
neural tissue
- This causes neural and perineural oedema and causes
demyelination of schwann cells, leading to the reduction of
nerve transmission
Define Rest pain Correct Answers Rest pain is persistent pain
caused by nerve ischaemia leading to ischaemic neuropathy
Define telangiectasia Correct Answers Telangiectasia are
permanent dilation of blood vessels
Define type 1 diabetes Correct Answers - The pancreas
produces little to no insulin and without it the body cannot turn
glucose into energy
- Without insulin the body burns its own fats as substitutes -
needs to be treated with daily injections of insulin (insulin
dependant)
