Diabetes And Endocrinology

Question 1

What steps should be taken on inspection in a diabetic foot examination?

Answer 1

Check patients shoes
Skin colour
Check plantar aspects of feet for ulcers or callus
Check between toes and nails for cuts or fungal infection
Look at lower legs and lift each to look at calf and heel
Deformities eg Charcot foot

Question 2

What steps should be taken to assess circulatory function in a diabetic foot examination?

Answer 2

Check temperature of both lower limbs to toes
Capillary refill time
Lower limb pulses

Question 3

What steps should be taken to assess neurological function in a diabetic foot examination?

Answer 3

Vibration sense
Assess soft touch using cotton wool on big toe
Assess sharp touch using neurotip on big toe
Monofilament test on five points on both feet (remember to clean monofilament before and after use)
Proprioception- only on big toe of each foot
Ankle reflexes

Question 4

What steps should be taken to assess musculo-skeletal function in a diabetic foot examination?

Answer 4

Plantarflexion and dorsiflexion at the ankle joint
Inversion and eversion at the mid-tarsal and sub-talar joints
Dorsiflexion and plantarflexion at the toes
Assess gait