diabetic foot

Question 1

what is a diabetic foot ?

Answer 1

infection, ulceration or destruction of deep tissue associated with neurological abnormalities

Question 2

what is the pathophysiology of foot ulcerations?

Answer 2

neuropathic
ischemic
neuro-ischemic

Question 3

what is lead pipe arteries a description of ?

Answer 3

atherosclerosis obliterans ( calcification of the media)

Question 4

what is autonomic system responsible for in the lower limb ?

Answer 4

regulates perfusion and sweating of the limb

Question 5

what does a loss autonomic control result in ?

Answer 5

inhibition of thermoregulatory function and sweating
leading to dry and cracked skin

Question 6

where are motor mainly seen ?

Answer 6

forefoot ulceration
intrinsic muscle wasting
equinous contracture

Question 7

what is the distribution in sensory neuropathy ?

Answer 7

starts distally and migrates proximally in stocking distribution

Question 8

what does a large fibre loss result in ?

Answer 8

loss of light touch and proprioception

Question 9

what does a small fibre loss result in?

Answer 9

loss of pain and temperature

Question 10

what are the two mechanisms of ulceration ?

Answer 10

• unacceptable stress few times

- acceptable or moderate stress repeatedly

Question 11

in uncertain cases of osteomyelitis what imaging modality is preferred ?

Answer 11

MRI

Question 12

what are the alarming signs associated with diabetic patients?

Answer 12

neuropathy
angiopathy
foot ulcers

Question 13

what are the stages of ulcer development ?

Answer 13

• callus formation
• subcutaneous haemorrhage
• breakdown of the skin
• deep foot infection with osteomyelitis

Question 14

what is the most important factor related to the outcome of diabetic foot ulcers ?

Answer 14

peripheral vascular disease

Question 15

what are supeficial infections usually caused by ?

Answer 15

gram +ve cocci

Question 16

what are deep infections usually caused by ?

Answer 16

polymicrobial

Question 17

when to suspect neuro-osteoarthropathy ?

Answer 17

in any swollen hot erythematous foot

Question 18

how should a diabetic foot ulcer be treated ?

Answer 18

• multidisciplinary approach
• staging to dictate the treatment options
• continuity of care and life long observation

Question 19

when is minor amputation needed?

Answer 19

• gangrene
• as part of debriment
• for correction of foot deformities

Question 20

what is the staging for diabetic foot ?

Answer 20

stage 1 - normal 
stage 2-high risk
stage 3 -ulcerated 
stage 4- cellulitic
stage 5-necrotic
stage 6- major amputation

Question 21

how are ulcers classified ?

Answer 21

Wagner's classification 
0 - intact ulcer
1- superficial 
2- deep to tendon bone or ligament 
3- osteomyelitis 
4- gangrene of toes or forefoot 
5- gangrene of entire foot

Question 22

what is an example of neuro-osteoarthropathy ?

Answer 22

charcot foot

Question 23

what is thee management for a diabetic foot ulcer ?

Answer 23

1. Off-loading​
2. Debridement​
3. Wound dressings​
4. Antibiotics​
5. Revascularization
   ​ 6. Amputation​

Question 24

what foot deformity is associated with charcot foot ?

Answer 24

rocker bottom deformity