Diabetic foot

Question 1

Name the 2 foot pulses

Answer 1

dorsalis pedis
posterior tibial

Question 2

What are the 3 types of sensation that are tested in a diabetic foot exam and what equipment is used?

Answer 2

light touch - semmes-weinstein 10g monofilament or fingers using Ipswich touch test

vibration - tuning fork

pin prick - neurotip

Question 3

Risk factors for ulcers in diabetic patients

Answer 3

previous amputation
past foot ulcer history
peripheral neuropathy
foot deformity
peripheral artery disease
visual impairment
diabetic nephropathy
poor glycaemic control
smoking

Question 4

Foot ulcer treatment in diabetes

Answer 4

treat any infection that may be present with appropriate antibiotics

debride any tissue that is dead or getting in the way of healing - podiatrist

offload the wound

revascularise as necessary

when in doubt - refer to specialist foot team

Question 5

What is charcots arthropathy?

Answer 5

relatively painless, progressive and destructive arthropathy in a single or multiple joints due to underlying neuropathy

bones become very fragile and start to break or dislocate in response to very minor forces

Question 6

How does charcots arthropathy present?

Answer 6

hot red swollen foot
temperature difference >2 degrees between feet

Question 7

Acute management of charcots foot

Answer 7

immobilisation in a total contact cast
pneumatic walkers
charcot restraining orthotic walker
rest
crutches

Question 8

Chronic management of charcots foot

Answer 8

footwear
orthosis
corrective surgery
health education
palliative podiatry