Diabetic Infection Workup

Question 1

HPI

Answer 1

NLDOCAT
systemic signs of infection (N/V/D/F/C/night sweats/LOA/SOB/CP)
Local signs of infection (Increased pain, erthyema, swelling, temp, drainage, odor)
Ulcer specific questions (duration, change in size/depth/color, odor, dressing changes/materials, last pod visit, last IM visit, previous tx, hx of hospitalization, ABX USE

Question 2

PMH

Answer 2

Complete DM hx including length of disease, previous complications, glucose schedule, nl glucose readings, A1C, meds, renal disease, liver disease

Question 3

Complete H+P

Answer 3

HPI (same as other flashcard)
PMH (Same)
PSH, Meds, All, SH, FH, ROS
Objective:
Vitals
Derm
Vascular
Neuro
Musc

Question 4

Ulcer classifications

Answer 4

Wagner, university of texas, PEDIS System, Liverpool Classification

Question 5

Wagner classification

Answer 5

0: Pre-ulcerative area without open lesion
1: Superficial ulcer (partial/full thickness)
2: Deep ulcer to tendon, bone, capsule
3: Same as 2 with abscess, osteo or joint sepsis
4: Localized gangrene
5: diffuse gangrene

Question 6

U of Texas classification

Answer 6

0: pre or post ulcerative site
1: Ulcers are superficial through epidermis or dermis
2: Wound penetrates to tendon or capsule
3: Wound penetrates to bone or joint
Stage A: clean
Stage B: nonischemic infected
Stage C: Ischemic
Stage D: infected ischemic

Question 7

Labs to order

Answer 7

CBC with diff, metabolic panel, HbA1C, ESR, CRP, Wound culture and sensitivity, blood cultures, bone biopsy