ENDOCRINE EXAM (PT ASSESSMENT III TEST #2) WITH VERIFIED SOLUTIONS ALREADY GRADED A+

What are the two main portions of the endocrine PE? -Thyroid exam -Diabetic foot exam History questions for a diabetic patient -Pain in calf when walking? -Changes in feet? -Shoe problems/discharge in socks? -Smoker? -Recent A1C result? What should you note during inspection of a foot exam? Condition of skin, hair, and toenails -Skin thin, shiny, hairless? -Are nails thick, too long, ingrown, or infected with fungal disease? What is charcot foot? destructive arthropathy resulting from impaired pain perception and increased bone blood flow from reflex vasodialation What are some MSK foot deformities commonly seen in diabetics? -Hammer toes -Claw toes -Bunions -Charcot foot What should be palpated in a diabetic foot exam? -Palpate for pedal pulses -Tender? Deformities? -Sensory testing What is the sensory exam of the diabetic foot exam? Using a nylon monofilament to test their sensation to touch *If they can feel it, they are at reduced risk for developing ulcers Where should you touch the foot with the monofilament test? *also at base of 4th toe Have patient tell you when they feel it How should you press the monofilament on the foot? Press filament to skin until it buckles and hold for 1-2 seconds What are the recommendations for low risk patients (for foot ulcers)? -Perform annual comprehensive foot exam -Assess/recommend appropriate footwear -Provide patient education for preventative self-care -Perform visual foot inspection When are patients considered high risk for foot ulcers? -Loss of protective sensation -Asent pedal pulses -Foot deformity -Hx of foot ulcer -Prior amputation How should you manage a high risk patient (for foot ulcers)? -Annual foot exam -Visual foot exam at every visit -Demonstrate preventative self-care of the feet -Always refer to a specialist if Charcot foot expected -Assess/prescribe appropriate footwear How do you manage an active ulcer or infection? -Never let patient with an open ulcer walk out in their own shoes (needs a weight relieving shoe) -Assess/prescribe therapeutic foot wear -Frequent wound assessment and provide care -Demonstrate preventative self-care techniques -Provide patient education on wound care -Refer to specialists and diabetes educator