Diabetic Foot

Question 1

A 45 urea old known diabetic man, presented with history of a non healing ulcer on the right foot. Take a focused history from him.

Answer 1

Grip
BIoODATA
Complain

Question 2

Course analysis Doctor

Answer 2

How long have you noticed it
Was it sudden or gradual
Where exactly is the ulcer located , on your right foot?
Is it single or multiple ulcer
Any discharge? If yes , how much, what color, any smell?
Have you noticed any temperature changes at the site of the ulcer
Has it changed in size or appearance since onset
Is it getting proper worse

Did it develop spontaneously or was it preceded by my scar, swelling or physical ulcer?

Any associated pain, itching, any bleeding, or skin changes like darkening of the skin

Have you noticed any loss of appetite, any fever or swelling in any part of the body?

Question 3

CAUSES

Answer 3

Where you diagnosed with DM
Are you compliant to medication
Do you adhere to diabetic diet
Do you exercise regularly
Any history of previous foot ulcer or amputation
Do you walk or stand for long
What type of shoes do you wear
Do you regularly check your foot for calluses or injuries
Do you walk barefooted

Question 4

COMPLICATIONS

Answer 4

Any history of fever with confusion and does your heart beat faster than normal? ( sepsis)

Any history of swelling, redness, or warmth around the ulcer ( cellulitis or osteomyelitis

Any pain history while walking or cold feet ( intermittent claudication )

Have you noticed any loss or abnormal sensation like walking on pebbles or numbness of the foot ( neuropathy)

Any foamy urine with leg swelling? Kidney or neuropathy)

Question 5

CARE SO FAR

Answer 5

What have you done since you noticed this ulcer
Have you been to any healing care facility, prayer house traditional doctor
Was any test done

Any treatment or medication, antibiotics, wound debridement, dressing, herbal concoction, traditional medicine.

Question 6

PAST MEDICAL HISTORY

Answer 6

Have you had similar symptoms in the past
Do you have any chronic illness like hypertension, epilepsy, asthma. diabetes or sickle cell disease

Have you had any blood transfusion, surgery, or hospitalization in the past?

Question 7

DRUG HISTORY

Answer 7

Are you on any long term medication
Are you on any current medication
Do you have any drug allergies

Question 8

FAMILY and social HISTORY

Answer 8

is there any one in your family with similar diseases ( HEAD)

Do your drink alcohol, do you smoke Do vou have multiple sexual partners
Are you on any long term medication
Are you on any current medication
Do you have drug or food allergies

Question 9

SYSTEMIC REVIEW

Answer 9

Sir, just to be sure I didn’t miss out any symptoms . I would like you to say yes or no to the following questions
UNS: any headache, any blurry vision , any loss of consciousness
ENDO: any neck swelling? Do you feel hot when other are cold.
any unexplained weight loss or weight gain
RESP: any cough, chest pain, difficulty breathing
CVS: are you aware of your heart beat, have you noticed that you are easily out of breathe any swelling on your bodv
especially the lower limbs
DIGESTIVE: and nausea, vomiting, and constipation, blood in stool
GUS: bloody urination, abnormal discharge . increased frequency in urination
MSS: any bone pain, joint pain, and difficulty walking, skin rash