DIABETIC FOOT EXAM QUESTIONS AND ANSWERS ALREADY GRADED A+.

diabetic neuropathy MC type of peripheral neuropathy affects sensory and/or motor nerves, can be focal, multifocal, or generalized and produce gait disturbances if loss of proprioception contributing factors: pivotal event, acute trauma, repetitive microtrauma, boney deformity, loss of protective sensation, CV disease wearing appropriate shoes how can a patient prevent occurrence and recurrence of diabetic foot ulcers? pes planus predisposes a patient to diabetic foot ulcers due to shifting of weight to the inside of the sole vs being evenly distributed hallux valgus bunion abnormal enlargement/inflammation of the joint at the base of the great toe tailor's bunion abnormal enlargement/inflammation of the joint at the base of the pinky toe paronychia, ingrown nails common signs of improper fitting footwear, which increases patient's risk for ulcers osteomyelitis any ulcer that extends to the bone increases the patient's risk of? peripheral artery disease significant risk factor for foot ulcers legs will present with hair loss, weak or absent pedal pulses, diminished or absent capillary refill all diabetics > 50, < 50 if multiple PAD risk factors (HTN, smoking, high cholesterol, etc) ADA's recommendations on ABI testing in diabetic patients every 5 years normal ABI results should be repeated? semmens weinstein monofilament test, absence of protective sensation in > 4 areas how is diabetic neuropathy confirmed? what are the findings? 10 g standard size of monofilament line used in semmes weinstein diabetic foot exam 0 foot risk category for diabetics with no loss of protective sensation 1 foot risk category for diabetics with loss of protective sensation, but no boney deformities or plantar ulcer history 2 foot risk category for diabetics with loss of protective sensation & either high risk of pressure sores or poor circulation patient often has callus/deformity and a low ABI 3 foot risk category for diabetics with a history of plantar ulceration, neuropathic fracture (charcot foot), or amputation yearly foot screens management of a diabetic in foot risk category 0 (other than patient education on disease control, proper shoe fit/design) follow up in 3-6 months management of a diabetic in foot risk category 1 (other than patient education on disease control, self inspection, early reporting of foot injuries, proper shoe fit/design) depth inlay footwear, modified shoes, follow up in 1-3 months management of a diabetic in foot risk category 2 (other than patient education on disease control, self inspection, early reporting of foot injuries, proper shoe fit/design) follow up 1-12 weeks management of a diabetic in foot risk category 3 (other than patient education on disease control, self inspection, early reporting of foot injuries, proper shoe fit/design) infection, ischemia off loading with a total contact cast in diabetics with a foot wound is contraindicated in? oral abx, possibly short term course of parenteral abx treatment of a non-limb threatening foot wound infection hospitalization, parenteral abx, surgical debridement treatment of a limb threatening foot wound infection hospitalization, abx for 6 or more weeks treatment of a foot wound infection causing osteomyelitis arteriography treatment option for diabetic foot ulcers, cannot be used unless infection is controlled goal is to restore pulse to the foot, helps promote healing, restore function, reduce pain, and reduce risk of amputation gabapentin, pregabalin anticonvulsants used to treat diabetic foot ulcer associated pain TCAs, SNRIs classes of antidepressants used to treat diabetic foot ulcer associated pain mexeletine antiarrhythmic used to treat diabetic foot ulcer associated pain clonidine alpha 2 agonist used to treat diabetic foot ulcer associated pain keratolytics what treatment for warts and calluses should diabetics avoid using due to their acidity and potential to damage skin? thx patient education for prevention of diabetic foot ulcers: - observe for changes in skin color or temperature - practice proper toenail care - no sandals or flip flops - avoid shoes that fit too tight or too loose - use moisturizers to keep skin soft