Diabetes

Question 1

What is the difference between large fibre and small fibre neuropathies?

Answer 1

Small fiber - mostly by clinical history and temperature loss

Large fiber - easily assessed with tuning fork or 10g monofilament

Question 2

Name 3 consequences of autonomic peripheral neuropathy that contributes to developing diabetic foot ulcers

Answer 2

Increased sympathetic tone

1. AV shunting
2. Small vessel ischemia
3. Change in skin turgor. (xerosis with loss of moisture balance and moisture which can lead to fissuring)

Question 3

What are the four stages of charcot neuroarthropathy?

Answer 3

0 - warm swollen foot

1-fragmentation, bony cysts and erosion

2-joint subluxation

3-arch collapse

4 - consolidation

Question 4

What is the definition of an equinus foot

Answer 4

Ankle dorsiflexion does not exceed 10 degrees

Question 5

What is a keller arthroplasty?

Answer 5

Improving hallux ulcer by resecting base of proximal phalanx to improve dorsiflexion

Question 6

How do you perform an achilles tendon lengthening?

Answer 6

2 transverse stab incisions medially and one laterally 1 cm apart to transect more ~50% of the tendon substance. Then forcibly dorsiflex the food to great a sliding effect of the tendon.

Question 7

What surgical procedure can off load for plantar ulcers?

Answer 7

Achilles tendon lengthening

Question 8

What is the recurrence rate of diabetic foot ulcers within 1 year?

Answer 8

50%

Question 9

After a DFU amputation, what is the rate of contralateral amputation?

Answer 9

50% within 2 years