Foot Flashcards
What is xerosis?
Dry skin
What is onychocryptosis?
Ingrown toenail
What is hyperkeratosis?
Corns/calluses
What are the characteristics of xerosis?
Dry, flaky skin
What is the protein that you lose as you age in the skin/
Epidermal filaggrin
What glads are lost that decrease sweating?
Eccrine glands
Which type of substances are well absorbed: hydrophobic or hydrophilic?
Hydrophobic
What part of the skin has a delayed recovery time?
Stratum corneum
What type of dysfunction is seen in DM pts that affects the skin?
Autonomic dysfunction
Tinea pedis is more common in what season? Why?
Winter due to low humidity
What is the stain to use to determine if fungi are present on a slide?
kOH
What are the three major foot problems in the elderly?
Tiea
Eczema
Psoriasis
What are the five treatments for xerosis?
Lanolin Water Urea AmLactin (lactic acid) Oatmeal
What drug should you use if there is fissuring/cracking of the skin?
1% hydrocortisone cream
What should you do if pts have really bad cracking of the skin?
Occlude with saran warp or socks
When should topical agents be applied to the skin?
After shower
What are the socks that you can buy to hydrate skin?
Silipos
What is the drug that you should use to kill tinea of the foot?
OTC Lamisil
What is the general rule to remember for skin?
If its wet, dry it out.
If dry, wet it
What is the enzyme that fungi produces that causes brittle toenails? What does it do?
Keratinase–destroys keratin
What are the causes of yellow nails? (TOECLYPT)
Trauma Onychomycosis Eczema Circulatory problems Lichen planus Yellow nail syndrome Psoriasis Tumor
How do you diagnose onychomycosis?
Lab
What is the usual cause of onychocryptosis?
Heredity ad improper nail trimming
When should nails be cut straight across?
Straight across only if the nails are normal
If there is a chronic problem with ingrown toenails, what should you do?
Remove some of the distal corner
Is the central V cut helpful?
No
True or false; some pts do better with in-grown nails if left longer than normal
True
What is the infection most common cause of paronychia? How you diagnose this?
Staph Aureus–just assume its this.
What is the treatment for paronychia? (3)
10 min warm water
Betadine solution
Cephalexin
What is the surgical treatment for paronychia?
Lance it
Bid soaks
Cephalexi
What is hyperkeratosis?
Thickened skin that is the result of intermittent pressure over the bones
When is hyperkeratosis bad?
If painful—means there is an ulcer beneath the callus
What happens if there is intermittent pressure over skin?
callus
What happens if there is constant pressure over skin?
Ulceration
What is the major complication of corns on the distal toes?
Osteomyelitis
What is the only layer o the skin that can be built up?
Stratum corneum
What causes the pain associated with hyperkeratosis?
Pressing against the sensory receptors in the underlying dermis
What is the treatment hyperkeratosis?
Debridement
Padding
Shoe modifcation
What is the shoe that can be used for hyperkeratosis?
Queen mary shoes
What are the two common digital bone deformities seen in the elderly?
Hallux valgus
Hammertoe
What is a bunion? What causes this?
normal first metatarsal that has moved medially due to a tendon imbalance
What is the treatment for bunion?
Extra depth shoes
Bunion shield
Toe separator
Surgery
What is a hammertoe?
PIP dorsiflexes
DIP plantar flexes
What causes a hammertoe?
Tendon imbalance
What is the treatment for hammertoes?
Debridement
Paddings
Splints
Shoes
What causes pes planus?
Progressive ligamentous laxity
What is the other name for flat foot/pes planus?
Pronation
What are the complications of pes planus?
Leg/back pain
MPJ pain
DJD
Tendonitis
Inflammation of the plantar fascia of the foot is called what?
Plantar fasciitis
Pain in the bottom of the heel + pain getting out of bed = ? Treatment?
Plantar fasciitis
Get ***
Do the bone spurs that occur with plantar fasciitis cause the pain?
No
What is the treatment for pes planus?
Arch support
What is the joint that you need to get pressure under to fix pes planus?
Talonavicular joint
What is the complication of vascular deterioration in aging?
Atherosclerosis, causing chronic venous insufficiency
What part of the body will show signs of vascular disease?
Foot for arteriole
Ankle for venous
What is the effect of DM on vessels?
Accelerates the aging of the arteries
What is the waist sizes for men and women with DM? What is the predictive value for this?
> 40 inches for men
35 inches for women
80% predictive value
What is the solution for a bad calcaneal ulcer?
BKAs
What is the treatment for atherosclerosis of the feet for DMs?
Deep shoes
Tight regulation of blood sugars
What is the level of HbA1C level that DMs should be below?
True or false: Medicare will pay for therapeutic DM shoes if you write a letter
True
What causes chronic venous insufficiency? Effects?
Damage to vein valves, causing congestion of blood and hypoxia
Venous ulcers will appear with what color?
Red
Arterial ulcers will appear with what color?
White, black, gray
venous insufficiency will eventually cause what?
Ulcerations
Chronic venous insufficiency can lead to what complication in the leg?
DVTs and PEs
What is the treatment for venous disease?
Compression hose
Numbness, tingling, burning in the foot can suggest what neurological diseases? (4)
DM
B12 deficiencies
Thyroid disease
EtOH-ism
What is the range of the compression hoes that most pts can tolerate?
20-30 mmHg
what percent of peripheral neuropathy pts do not have an identifiable etiology?
40%
What percent of DM neuropathy is caused by something OTHER than hyperglycemia?
10%
Inability to perceive pain or pressure in the foot will cause what?
ulceration
What number of areas out of the 10 tested by the monofilament suggests anesthetics peripheral neuropathy?
What is the treatment for DM peripheral neuropathy?
Control blood sugars
Lyrica
True or false: there is NO cure for a loss of sensation in distal extremities of DM
True