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TOSCE > Common Foot Disorders > Flashcards

Common Foot Disorders Flashcards

1
Q

factors contributing to corns and calluses

A 
friction from loose or tight fitting shoes 
not wearing socks with shoes 
ill fitting socks 
walking bare foot 
weight gain
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2
Q

what does a corn look like

A

small raised and well defined lesion

has a central core that is triangular shaped and points inward (hole in middle)

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3
Q

signs and symptoms of a hard corn

A

well defined
yellowish grey
mm-cm diameter
shiny, dry, and polished with loss of natural skin pattern
central core visible
pain
occurs on skin directly overlying bony prominence or on soles of feet
usually surface of the fourth or fifth toes

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4
Q

signs and symptoms of soft corns

A

whitish thickenign of skin
soft appearance
WEBS between 4th and 5th toes
may be painful

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5
Q

what is a plantar corn

A

corn on the underside of the foot that causes pain when walking

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6
Q

signs and symptoms of a callus

A

yellowish white
normal skin pattern with no central core
borders not well defined
few mm -cm diameter
slightly elevated
where upper layers of skin are naturally thick

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7
Q

what are plantar warts

A

benign tumors caused by HPV viral infection

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8
Q

why is it important to treat plantar warts when they are benign and will spontaneously clear

A

can spread
unsightly
can be painful and restrict activities
may transform into malignant lesions

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9
Q

where can plantar warts occur that is not a referral

A

sole of foot or heel
great toe
head of metatarsal bone

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10
Q

what are signs and symptoms of plantar warts

A 
circular lesion with wart in the center 
.5-3 cm diameter
surfacr rough and grayish brown, easily crumbles 
surrounded by skin that is thick and heaped
normal pattern of skin is interupted 
black dots in center of lesion 
single or in clusters 
painless unless direct pressure applied
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11
Q

difference between athletes foot and soft corn?

A

athletes foot is itchy not painful and may have an odor

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12
Q

goals of therapy for corns and calluses

A

remove corn and calluses
prevent/minimize complications
prevent recurrence

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13
Q

what is the first line treatment of corn and calluses

A

salicylic acid

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14
Q

advantages of sa collodion

A

forms film to prevent moisture loss

less likely to run onto other areas of skin

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15
Q

disadvantages of sa collodion

A

takes longer to resolve
occlusive nature allows systemic absorption
more irritating

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16
Q

advantages of plasters/disk/pads

A

direct and prolonged contact with skin
plasters may be cut to fit size of lesion
disk/pads convenient

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17
Q

disadvantages of plasters/disks/pads

A

patient may be sensitive to adhesive

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18
Q

what should collodions be used for and for how long

A

soft corns

3-6 days

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19
Q

what should the adhesives be used for and how long

A

hard corns and calluses
5 treatments over 2 week period max (1treatment = 48hrs)
until condition resolved

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20
Q

directions for use of collodion

A

soak foot for 5 min and dry
apply 1 drop at a time until area i well convered
allow drops to dry and harden
do not let adjacent areas of skin come in contact with drug (put vaseline on skin around)
once or twice daily

21
Q

directions for use for plasters

A

soak foot for 5 minutes and DRY
trim to follow contours of lesion
apply and cover with adhesive tape
remove within 48 hours

22
Q

directions for use for disks and pads

A

soak foot for 5 minutes and DRY
apply appropriately sizzed on area and cover
remove within 48hours

23
Q

what should you do along with all of the treatments

A

soak in warm water and remove dead tissue with a pummice stone or callus file

24
Q

non pharms for corns and calluses

A 
eliminate cause of condition 
foam or cushion pad with opening to relieve pressure- change everyday 
custom pads from moleskin or lambs wool 
orthotic devices 
keep feet clean and dry 
avoid moisturizers between toes 
select properly fitted footwear
25
Q

monitoring for corns and calluses

A

visible improvement in a few days
resolution for hard corn/callus in 14 days, 3-6 days for soft corn
refer to doctor if allergic reaction develops, skin irritation, skin ulcers, stinging that is bothersone, infection develops (red, warm, discharge)

26
Q

goals of therapy for plantar warts

A

alleviate or prevent pain due to wart
eradicate lesions adn prevent their proliferation
prevent recurrence
prevent transmission

27
Q

what is the first line treatment for plantar warts

A

salicylic acid

28
Q

how does sa work

A

keratolytic

removes skin cells infected with HPV and causes inflammation which induces an immune response

29
Q

how does lactic acid work

A

corrosive properties

enhances sa

30
Q

how does formalin work

A

antiviral and anhydrotic

31
Q

how does cantharidin work

A

vesicant which causes blister to form and cells die

32
Q

how does DME and propane work

A

freezes wart and causes a blister to form under it, wart falls off 10-14 days after treatment

33
Q

SA treatment options for plantar warts

A

sa collodion- OD–BUD max 12 weeks
sa plaster/disk- wvery 48 hours for max 12 weeks
sa in karaya gum- apply at night for 8 hours for max 12 weeks

34
Q

other product for plantar warts

A

wartner and freezeaway- apply to wart for 10-40 seconds may repeat in 14 days up to max of 3-4 times

35
Q

non pharms for plantar warts

A

advice they are contagious
avoid walking barefoot
change shoes and socks daily
keep feet clean and dry
dont share or touch possible infected objects or peopls
wash hands before and after cleaning feet and caring for wart
do not bite, scratch, poke, or cut wart tissue
dont use sharp knives or razors
use good foot hygiene

36
Q

how can duct tape be used for plantar warts

A

cause irritation
apply to wart for 6 days then remove and soak foot
soak throughout treatment for 5-10 min in warm water and gently remove dead tissue
can take up to 2 months not the best option

37
Q

monitoring for plantar warts

A

improvement should be seen in 1-2 weeks
wart removal may take 4-12 weeks
warts may reappear months after initial treatment
refer to doctor if develop an allergic reaction, skin becomes damage painful inflamed or infected, if any wart persists after 12 weeks of treatment

38
Q

side effects of SA

A

redness burning or irritation

39
Q

when should you not use SA

A 
irritated, infected skin
face, mouth, nose, anus, genitals, lips 
patient takes salicylates, anticoagulants, LMW heparin  
pregnancy and breastfeeding??
under 3 or over 65
40
Q

precautions of SA

A

apply petroleum jelly to surrounding skin
highly flammable
poisonous if swallowed or inhaled

41
Q

side effects of DME/propane products

A

aching, itching, burning,stinging, dont use on thin skin can cause scars

42
Q

precautiosn of DME/propane products

A

unknown in pregnany and lactation
not in under 4
not in hard to reach location
flammable only one wart at a time on toe

43
Q

what is a bunion

A

deformed big toe joint
joint angled out and big toe angles inward toward other toes
can also be on 5th toe

44
Q

factors contributing to bunion

A 
inherited 
women 
constatn abnormal joint motion 
improper fitting shoes or high heels 
occupation that puts stress on feet 
vigorous exercise 
foot injurues 
rheumatoid arthritis
45
Q

signs and symptoms of bunions

A 
usually bilateral 
bump on outside edge of big toe 
thickening of skin at base of big toe 
asymptomatic but can become red, painful, swollen, tender 
restricted movement of big toe
46
Q

bunions are a referral what can you do in the meantime

A

remove source of irritation
select properly fitting footwear
modify activity
moleskin, foam, cushioned pads
bunion guard- soft polymer gel with no adhesive
ice packs and OTC pain relievers to decrease pain and swelling

47
Q

red flags for warts

A

extensive at one site
on mucous membranes, face, anus, genitalia, under nails
extremely painful and debilitating
unusual appearance

48
Q

red flags for corns or calluses

A

indicate an anatomic defect or fault in body distribution
lesion oozing purulent material or is bleeding
extensive, painful, or debilitating

49
Q

red flags for all foot conditions

A 
diabetes, peripheral circulatory disease
malnourishment 
immunocomprimised
rheumatoid arthritis 
physical/mental impairments making following instructions difficult 
allergic to treatment options - ASA, adehsive 
proper self medication has been unsucessful 
under 3 or over 65
pregnan
infected, red, swollen, inflammed
looks like mole or birthmark 
hair growing from lesion

TOSCE (4 decks)

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