Diabetic Foot Care Flashcards
What is the most common cause of hospitalizations in diabetics?
problems related to their feet
What is sensory neuropathy?
Nerve Damage with symptoms of numbness, burning, tingling, pins and needles
What is motor neuropathy?
Nerve Damage leading to musculoskeletal deformities
What is autonomic neuropathy?
Nerve Damage to autonomic nervous system: dry feet, loss of hair in lower extremities, greater chance of infection
How do you do sensory testing of the feet?
monofilament perpendicular to the foot. Not over areas of callus or broken skin. 2-3 seconds after monofilament buckles. Significant for neuropathy if unable to feel < 6 sites
How is a vibration test interpretated?
if the patient correctly answers at least two out of three applications the test is positive, and negative (‘at risk for ulceration’) if vice versa.
What vascular tests should you perform to test peripheral disease?
Palpation of foot pulses – Dorsalis Pedis and Posterior Tibialis arteries. Capillary Refill Testing.
Doppler Testing. Edematous Changes
What are signs of arterial disease?
Intermittent claudication, thin, shiny skin with lack of hair, Lack of subcutaneous “padding,” or dusky red/cyanotic/grey color
What musculoskeletal deformities are associated with diabetes?
High arch feet (Pes Cavus), Bunions, Claw and hammer toes, Deformities due to past, trauma/surgery, Past ulceration sites, Charcot foot
Why are diabetic foot infections hard to treat?
extra sugar for bacteria and decreased blood flow even in diabetics with good control
Describe cellulitis infection and treatment in diabetics?
superficial skin infection caused by Group A & B Strep, & S. Aureus. treat with cephalosporins or clindamycin
What are treatment guidelines for deep skin and soft tissue infection in diabetics?
Deep Wound Culture, CBC, ESR, systemic signs of infection, blood cultures, blood sugars. Abx, debridement, offloading, dressing changes
Describe acute osteomyelitis and its treatment in diabetics
Infection down to the bone caused by S. Aureus. Watch for MRSA. Check Blood Sugars, CBC, Culture, ESR. Abx, debridement, infectious disease consult, podiatry consult
What is Charcot foot?
Destructive Arthropathy resulting from impaired pain perception and increased bone blood flow. Bone becomes washed out & weak resulting in small periarticular fractures until joints become destroyed. Most commonly involves the midfoot joints
What is the clinical presentation of Charcot foot?
Painless swelling is hallmark sign, painful foot when normally neuropathic, or bounding pulses. Usually the result of trauma and impaired sensation caused by neuropathy. treatment is immobilization
