diabetic foot neuropathy Flashcards

1
Q

what are the complications of diabetes that predispose to foot disease?

A
  • neuropathy (sensory, motor, autonomic)

- peripheral vascular disease

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2
Q

how do you test sensory function?

A

via mono-filament

when the filament bends, 10g of pressure has been applied which should be felt by patient

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3
Q

what is the pathway to foot ulceration?

A
  • sensory neuropathy
  • motor neuropathy
  • limited join mobility
  • autonomic neuropathy
  • peripheral vascular disease
  • trauma
  • reduced resistance to infection
  • other (diabetic complications)
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4
Q

what happens in sensory neuropathy?

A
  • cannot feel monofilament

- ulcers due to abnormal pressures

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5
Q

what happens in motor neuropathy?

A
  • imbalance of extensors/flexors so foot is abnormal shape

- ulcers due to abnormal pressures

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6
Q

what happens in limited joint mobility?

A

causes joint immobility

cannot put hands flat against each other

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7
Q

what happens in autonomic neuropathy?

A

no sweating so skin dries out and you get ulcers

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8
Q

what happens in peripheral vascular disease?

A

blood flow is compromised to lower limbs

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9
Q

what happens in trauma?

A

repeated or minor episodes

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10
Q

from a diabetics perspective, what must be managed?

A
  • hyperglycaemia
  • hypertension
  • dyslipidaemia
  • stop smoking
  • education
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11
Q

what are the preventative management options?

A
  • controlling diabetes
  • attend chiropodist
  • take care when feet will get hot
  • inspecting feet daily
  • cut nails straight across
  • never walk barefoot
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12
Q

what is the management of foot ulceration?

A
  • relief of pressure (bed rest and redistribution of pressure)
  • antibiotics
  • debridement
  • re-vascularisation
  • amputation
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13
Q

what is charcot foot?

A
  • bones orientated in abnormal way
  • “rocker bottom foot”
  • painful to non-diabetics but not for diabetics due to sensory neuropathy
  • deformity due to loss of join-position sense
  • abnormal shape predisposes to osteomyelitis
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14
Q

what is the difference between osteomyelitis and charcot foot?

A
  • osteomyelitis: bone infection

- charcot foot: destruction of joints

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