Diabetic foot exam Flashcards

1
Q

What things are done at the beginning of a diabetic foot exam?

A
  • Asses gait (peripheral neuropathy can cause slow, painful, unsteady gait)
  • Inspect footwear (for uneven wear, anything causing injury)
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2
Q

What are you looking for on inspection in a diabetic foot exam?

A

Inspect all aspects of lower limb (including between toes and behind heel)
- Colour (cyanosis/pallor/erythema): poor perfusion/infection
- Ulcers (arterial/venous)
- Scars
- Missing limbs/toes/fingers
- Hair loss/decreased sweating/dry skin: autonomic dysfunction
- Infection (gangrene/cellulitis)
- Calluses: abnormal gait, poor footwear
- Deformities: high arch/flat foot, clawed/hammer toes

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3
Q

What do you need to palpate in a diabetic foot exam?

A
  • Temperature
  • Bones/joint tenderness
  • Capillary refill
  • Posterior tibial pulse
  • Dorsalis pedis pulse
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4
Q

What is tested for the neurological assessment in a diabetic foot exam?

A
  • Sensation with a monofilament
  • Vibration
  • Proprioception
  • Ankle reflex
    • test sensations in the toes, if not present move higher
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5
Q

What further assessments could be done to complete a diabetic foot exam?

A
  • Bedside capillary blood glucose
  • HbA1C
  • Lower limb neurological exam
  • Peripheral vascular exam
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