DSP test Flashcards
Glycosuria
excess sugar in urine
due to untreated diabetes –> kidney did not reabsorb all the glucose therefore glucose failure
Feet that are blue and lack sensation - what does it mean?
It means that the feet do not have enough blood supply and not enough oxygen going there.
Painful foot due to blood clot
Congestion of blood therefore the tissues become hypoxic (not enough CO2) –> cell death
Antibodies that don’t work, is the infection inflammation/infection?
If it was infection/inflammation the antibiotics should work.
Ischaemia
Restriction of blood supply to tissues, resulting in a lack of oxygen and glucose needed for metabolism
Aetiology of ischaemia
Blood clot / thrombosis
Pes cavus
high arched foot
Adhesions
car tissue in a body cavity (sticking together) –> organs sticking together, restriction of movement
NSAIDS
non-steroidal anti-inflammatory drugs
prevent adhesions and inflammation
What surrounds the tendons of an ankle joint?
synovial tendon sheaths
Why would you need ice to be put on a certain area?
To reduce vasoconstriction
Iatrogenic
Disease caused by medical intervention
Nosocomial
Disease contracted in a hospital environment
Transmission of a disease in a hospital setting
Cross contamination Inadequate sterilisation (process of getting the instruments completely free of organisms)
HBV (acute hepatitis B)
Chronic inflammation of the liver
Chronic inflammation
Inflammation that induces lymphocytes and macrophages (natural killer cells) and macrophages undergoing phagocytosis to go to the site of infection
Acute inflammation
Inflammation that brings neutrophils to the infected site (therefore there is pus seen at the site)
Plantar Fasciitis
Pain in hell and plantar surface of the foot.
- -> inflammation, fibrosis, structural deterioration of the plantar fascia.
- -> musculoskeletal disorder affecting 3-7% of the general population
Why should plantar fasciitis be treated?
It causes further issues and problems. Inhibits daily function.
Capsulitis
Inflammation of an organ/part or between toe joints
Why should capsulitis be treated with inhibition of inflammation response?
Capsulitis needs inflammation to occur.
Also prevents contractures and deformities.
Contracture
Abnormal shortening of muscle. The scar tissue causes distortion and deformity
Contraction
Skin contraction, an essential part of healing process.
Decubitis ulcer (what is it and what are the complications?)
Bedsore
Pressure induced ulceration of the skin occurring in persons confined to the bed for a long time
Tissues become necrotic ischaemia and therefore erode.
Complications –> exposure to bacteria and viruses
Enchondroma
benign growth of cartilage tissue
–> destroys bone
Does enchondroma have any harmful effects?
Foot pain
Enlargement of affected toe (destroys bone in the localised area as it is encapsulated and cannot go elsewhere)
slow bone growth
Verruca plantaris
wart on the plantar surface of the feet
– caused by HPV
Acral lentiginous melanoma
irregular, enlarging black macule with prolonged noninvasive stage, occurring chiefly on palm/soles
Chemotherapy
kill cancer cells
can work on metastasised cells as well
Radiotherapy
ionising radiation to a localised area by beaming/inserting into tissues
Doesn’t work on metastasised cells
Skin cancer on the lower extremities
30% of all primary cutaneous melanomas are on the lower extremities
What is the podiatrist’s role of recognising/diagnosing skin cancer?
recognise, but no need to diagnose. refer to a specialist health professional for that.
Swelling in the ankle and leg
blockage accumulation of the blood
Discolouration of the leg
Due to clotting
Developing a DVT?
Obesity Best Rest (fatty tissue can compress the veins) Economy class syndrome
Swollen legs and ankles (left and right side heart failure)
Right side heart failure (due to left side heart failure)
there is an increase in fluid pressure therefore damaging the right side.
leads to right side losing pumping power
blood backs up int he body’s veins therefore there is swollen legs and ankles
Silent myocardial infarct
necrosis, obstruction and ischaemia
however there are no symptoms
Why did a thrombus form on a myocaridal infarct?
Damage on the arterial wall therefore aggregation of inflammation and healing therefore there is extra clotting
Pulseless lower limb
thrombus cause on obstruction of blood supply to the lower limb
Occlusion (sudden or gradual?)
sudden
acutely ischaemic right lower limb
if it was gradual you would feel pain
Normal blood pressure ?
90/50 - 120/90 mmHg
ABI
ankle brachial index
Normal ABI value?
1.0-1.2
lower it is, the more there is arterial disease. if it is above, there is abnormal vessel hardening
Risk factors for cardiovascular disease
FH
smoker
HT
hypercholesterolaemia
Intermittent claudication
clinical diagnosis for muscle pain especially calf muscles
obstructs arteries
insufficient blood flow
metabolic demand increase, therefore requires more oxygenated blood but cannot because ischaemic pain
Weakness and difficulty walking
blood clotting, TIA, stroke
dribble mouth, cannot dorsiflex very well, shoulder drop
Risk factors
HT, age, CV disease, HBP, lifestyle, diet, FH
Normalative value for a fasting BGL (blood glucose level)?
4-6 mmol/L
Injecting insulin in a person with type 2 diabetes
hyperglycaemia damages the pancreas therefore cannot produce insulin properly. so must inject insulin to compensate for lack of insulin
Microangiopathy
Disease in the small blood vessels affecting the basement membrane, kidneys and feet.
Body organs that are susceptible to damage due to microangiopathy in diabetes?
peripheral circulation, kidney, capillaries
Underlying disease process that leads to microangiopathy in diabetes?
hyperglycaemia –> stimulates endothelial cells to reduce lumen and therefore causes thickening of the basement membrane
Addressing onychocryptosis for the long-term?
foot wear choices, poor blood flow therefore less blood circulating to the infected area
why does diabetes = increased risk of infection?
bacteria grow in sugary environments (hyperglycaemia) and leads to increased chance of infection
Reviewing patients
Every 4-6 weeks
What do you say when you refer them to the GP?
Tell them what you’re going to do, what their problem is and get them to to prescribe medication accordingly.
