Foot Care Flashcards by Jordan Cyr

What are calluses?

localized area of thickened skin

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What causes calluses?

weight-bearing on friction points

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What can be done to treat calluses, if anything?

new footwear
pumice stone
callus remover
protective material

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If a guy has bad scaling and even bleeding around his heels, what can be applied to the heels as some protection?

liquid bandage

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How do the pliable disk versions of callus removers work?

contains a medicated disk with 40% salicylic acid (keratolytic) and a cushion to cover and protect the disks

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How do liquid versions of callus removers work?

comes as 15% liquid salicylic acid, apply to callus, let SA (~10s), and then cover with cushion
-the cusions probably arent large enough for calluses
-more so for corns

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What are corns and what causes them?

hyper-keratotic growth
reaction to local friction/trauma over a joint
body saying we need protection

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What is the difference between soft corns and hard corns?

hard corns: develop on top of toes
soft corns: develop between toes or on the side of toes

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What is the treatment for corns?

remove cause (best move)
protective material (pick spots, cut to desired size)
Scholl corn cushions (foam only)
salicylic acid preps
-cushion+pliable disks 40% sa
-cushion+15% liquid sa

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What are the directions of use for the cushion+pliable disks 40% salicylic acid for corns?

soak hard corns first (~5mins)
OD-Q2d
treatment period ~6 days

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What is the downside of the disk salicylic acid preps?

they are one size fits all so healthy skin will get hit by the salicylic acid

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What are the directions for use of 15% liquid salicylic acid+cushion for corns?

soak hard corns first (~5 mins)
apply to corn, cover with cushion
OD-BID
treatment period ~6 days

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What is a must when treating soft corns?

covering with a band aid or cushion to prevent salicylic acid from hitting healthy skin

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What are bunions?

swelling of joint via deviation of big toe

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What are the causes of bunions?

structural defect (heredity)
exacerbated by shoes

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What are the treatments for bunions?

orthotic devices/species shoes (podiatric care)
bunion protective pads (JT doesnt recommend)
-cushion, NO disks
-more pressure when wearing a shoe
Scholl ToeFlex
surgery

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What is the cause of ingrown toenails?

jagged edges of nail starts digging into pulp of foot

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What is the treatment for ingrown toenails?

file off the edge of the nail=best
benzocaine 20% (probably wont penetrate and nail tag is still there)
Scholl Toenail Softening (edge is still present)
foam cap (low value)

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When a patient is asking how to file the edge of an ingrown toenail, when should you consider referring them to nursing or medical care to get it done?

base it on if you think the patient is capable of doing it themselves

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True or false: an Epsom salt foot soak will drain an infected ingrown toenail

false

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What is bromidrosis?

unpleasant smell via bacterial breakdown of sweat

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What is the treatment for smelly feet?

looser fitting shoes
wash feet (more often than currently done)
socks (cotton>synthetic, change more often)
foot powders and sprays

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What is the idea behind diabetic socks?

they contain silver which has some antibacterial properties

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What is the cause of warts?

human papilloma virus

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How are hand warts transmitted?

skin to skin self-inoculation

True or false: 25% of hand warts spontaneously regress

true but this could mean 1 year, treat them, dont wait

What are the symptoms of hand warts?

ranges from being a cosmetic nuisance up to being painful

What are the directions for use of Duofilm liquid (sa + lactic acid) for hand warts?

soak first rub off dead skin apply drops OD x 8-12 weeks (Compound W is 8 weeks) *apply Vaseline at base to protect healthy skin*

Which formulation of salicylic acid prep should you choose for warts?

gel rather than liquid -liquid can dry out faster, even when the bottle is closed

What is critical with wart treatment?

killing the root

What happens if you dont kill the root of a wart?

the wart can come back

Does treating beyond the area of a wart actually widen the wart?

it potentially can apply only to the wart

What is the issue with Duofilm patch (salicylic acid patch) in wart treatment?

its one size fits all thus you will hit healthy skin also takes several months of treatment

What are the directions for use of OTC freezing products for warts?

1. stick foam device into clasp 2. press the foam+clasp down into the container for 2-3s 3. apply to skin for 20s

How long does one activation of an OTC freezing product last on your HAND before you must re-load the device?

20s

What is the duration of therapy for OTC freezing products for hand warts?

every 2-3 weeks with about 4 repeats

What is the verdict on the use of duct tape for hand warts?

probably works (irritant + macerating) daily use x 2 months cut to fit

What are some oral therapies that are showing some evidence for warts?

zinc (~600mg which is not OTC) cimetidine

What are the therapies you can recommend for hand warts for kids?

salicylic acid OTC cryotherapy *let the parent decide*

When do we refer kids for warts?

on face multiple lesions

What is a condition that looks like warts seen in kids?

molluscum -viral -usually painless -spread by direct contact -10 to 20 lesions

What is the treatment for molluscum?

cryotherapy curettage lasers

What are juvenile warts?

in kids, generally on face smaller and smoother than other warts best treated by MD

What is a classic but small detail with plantar warts?

tiny black dots on the wart -dead vessels

True or false: we care about treating the core of a corn, we dont care about treating the core of a plantar wart

false both have cores but we only care about the core of plantar warts

Lets say someone came in with what you believe to have been a plantar wart and you recommended a salicylic acid prep. Later you discover it was actually a corn. How serious is this mistake?

not serious, assuming you recommended a salicylic acid prep treatment is the same, they just differ in duration

If using the Scholl Wart Remover (40% sa), how long is treatment for warts? What about corns?

warts: 12 weeks corns: 2 weeks

How long do you need to apply OTC cryotherapy products to plantar warts (one treatment, not total duration of therapy)?

40s -may need to re-charge device

What is critical that you must do before performing cryotherapy to a plantar wart?

soak your foot

How cold are the OTC cryotherapy products compared to liquid nitrogen?

OTC cryo: -70 C liquid nitrogen: -190 C

What is the Dr Scholls Dual Action wart remover? What are the directions for use?

comes with cryo and sa freeze area, then apply salicylic acid OD x14 days repeat x 4 cycles

What are the directions for use of salicylic acid liquid/paste/gels for plantar warts?

OD to Q2d x 12 weeks -gel lasts longer

Do we want to use salicylic acid products in a band-aid (one size fits all) for plantar warts?

no gonna hit healthy skin with sa

What is a prescription product for plantar warts?

Canthacur products (cantharidin) -via blister beedle

What are the directions of use for cantharidin for plantar warts?

use Q-tip or applicator stick to apply to wart and 1-3mm around wart allow to dry secure with non-porous adhesive plastic tape leave in place for 1 week then debride *three or more treatments may be required for large lesions*

Can you use H2O2 followed by Vicks VapoRub on a plantar wart?

has been shown to work H2O2 is antiseptic and probably doing nothing, Vicks will be a irritant to the wart apply OD x 14 days (be sure to cover)

What is plantar fasciitis?

pain on bottom of the foot running from the heel bone all the way to the front of the foot rips and tears that lead to inflammation

When does plantar fasciitis hurt the most?

in the morning -rips and tears healed overnight and then they rip when you get out of bed in the morning

Would you recommend a plantar fasciitis sleeve or physio to someone suffering from plantar fasciitis?

physio -far more faith in stretches than sleeve

What is the Strassburg sock designed to do?

designed to make the healing position be in a stretched position overnight -for plantar fasciitis -prevents the morning tear and rip

Are NSAIDs a good therapy for plantar fasciitis?

highly unlikely (this includes Voltaren) plantar fasciitis does not result from inflammation, it results from repetitive microtears

What do 50% of people with plantar fasciitis develop?

heel spur (bone spur dead on in heel)

What are some remedies that a podiatrist might recommend for someone with a heel spur?

shoe inserts stretching icing the arch sound waves night splints

What is the average time to heal for heel spurs?

9 months

True or false: a pharmacist can differentiate between plantar fasciitis and a heel spur

false

What is a medical condition that we never self-medicate for corns or warts?

diabetes

What is a medical condition that you should ask about when presented with a foot case?

"are you diabetic?" or "is your son/daughter diabetic?"

What are skin tags and where are they commonly found?

soft, easily movable tissue similar in colour to surrounding skin neck, under arm, under breast

What is the treatment for skin tags?

cryotherapy with a different tip max 2 applications per lesion