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Prosthetics > Prevention > Flashcards

Prevention Flashcards

1
Q

T or F: most amputations are preventable

A

T

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2
Q

Top cause for amputations?

A

peripheral vascular disease
*trauma is second

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3
Q

risk factors for vascular disease

A
  • smoking
  • HTN
  • atherosclerosis
  • DM
  • high cholesterol
  • age older than 60
  • black race
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4
Q

what is the classic symptom of PAD?

A

pain in the legs with exertion that is relieved with rest

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5
Q

T or F: everyone with PAD has leg pain

A

F: 40% don’t

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6
Q

what are some behaviors that can prevent and reduce symptoms of PAD?

A
  • exercise
  • avoid smoking
  • control HTN, cholesterol, and DM
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7
Q

what is the leading cause of limb loss

A

DM

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8
Q

where is DM most prevalent

A

southeast

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9
Q

is type 1 or 2 DM more common

A

type 2 90-95% of people

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10
Q

risk factors for DM

A
  • increased age
  • lack of exercise
  • family hx
  • socioeconomic conditions
  • obesity
  • race/ethnicity
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11
Q

T or F: the incidence of DM has decreased

A

T: new cases appears to be slowing

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12
Q

pre-diabetes

A

blood sugar levels higher than normal but not high enough for DM dx
*increased risk of type 2 DM, heart disease, and stroke

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13
Q

T or F: a health care disparity exists for the prevalence of diabetes

A

T: minority groups more likely to be diagnosed with diabetes

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14
Q

T or F: s higher percentage of those without a high school degree had diabetes compared to those with a degree

A

T

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15
Q

T or F: type 2 diabetes is decreasing in children

A

F: its increasing

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16
Q

T or F: preventative methods for diabetes seems to be helping

A

T: they are helping to decrease the rate of amputation

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17
Q

T or F: end state renal disease is heavily linked with amputation

A

T

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18
Q

those w/ DM should often be refered to a…

A

nutritionist
exercise specialist

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19
Q

recommended cardiovascular exercise for those with DM

A

150 mins of mod to vig PA a week
*RPE can be used to measure

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20
Q

what kind of training can lead to rapid improvements in glucose control in those with type two DM

A

low volume, HIIT training

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21
Q

what heart rate should you be at for hit

A

70-90% of max

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22
Q

if your patient has a family and is busy, what is a big benefit of HIIT

A

time efficient, only takes about ten minutes

23
Q

what should those with type 2 DM have done before doing vigorous exercise

A

12 lead ECG screening

24
Q

_____% of amputations related to DM complication could have been prevented

A

60%

25
Q

about _____% of DM related amputations are preceded by a foot ulcer

A

85%

26
Q

“at risk” root

A

pts w/ DM, PVD, and renal disease who are considered highly susceptible for developing a foot ulcer

26
Q

the presence of a foot ulcer is associated with a ______ fold increase in amputation risk among pts w/ DM

A

five

27
Q

“high risk” foot

A

pts who has had an amputation for any reason and pts with a foot risk score of 2 or 3

28
Q

a combination of what 3 things usually leads to skin opening

A

1 - poor circulation
2 - sensory loss
3 - mechanical issues
*skin opening places you at risk for deep infection and then emputation

29
Q

as you apply higher loads, the chances of ulceration _________

A

increases
*footwear impacts this

30
Q

repeated moderate pressure leads to ______ which then leads to ________

A

inflammation
ulceration

31
Q

is polyneuropathy or mononeuropathy more common

A

poly

32
Q

3 systems affected with neuropathy

A

sensory
motor
autonomic

33
Q

neuropathic pain is worst at ______ and relieved with ________

A

rest
walking and at night

34
Q

T or F: neuropathy is influenced by elevation

A

F

35
Q

________- dysfunction in neuropathy leads to elevated forces and altered area of contact

A

motor

36
Q

hammertoes

A

flattening of distal phalanges

37
Q

claw toes

A

hyperextension of the MTP joint and flexion of the PIP and DIP joints

38
Q

autonomic dysfunction in neuropathy sx

A
  • impaired sweat glands
  • reduced sweating
  • dry skin and cracks
  • altered vasomotor regulation
  • dilation of arterioles
  • bulging, warm, red foot
39
Q

2 ADA recommended ways to examine vascular status in feet

A
  • pulses
  • ABI
40
Q

two pulses you check for vascular status

A

dorsalis pedis
posterior tib

41
Q

pulse measurement scale

A

0 - absent
1 - weak
2 - normal
3 - full
4 - bounding

42
Q

WNL ABI

A

0.9-1

43
Q

impaired flow of ABI

A

<0.9

44
Q

unlikely to heal distal wound ABI

A

<0.5

45
Q

two electro diagnostic tests for sensory fx

A

nerve conduction velocity
electromyography

46
Q

4 quantitative sensory measurements

A

pressure
vibratory threshold
pinprick sensation
ankle reflexes

47
Q

charcot deformity

A
  • complete collapse of medial arch
  • very flat foot
48
Q

if you have had an amputation, PVD, or an ulcer you are automatically a _______- risk foot

A

high

49
Q

what kind of inserts are often used as ulceration/amputation prevention

A

soft

50
Q

5 rules for orthotics/shoes

A

1 - contours of shoes most closely match contours of feet
2 - widest part of forefoot should be widest part of shoe
3 - length should be 1/2 inch between end of the longest and end of shoe
4 - roomy toe box
5 - try on late in the day

51
Q

3 ways to reduce pressure during gait

A
  • limit push off
  • reduce speed
  • reduce step length
52
Q

the VHA developed PAVE. what does it do?

A

tracks everyday at risk individual from date of entry into the healthcare system through all the appropriate healthcare levels

Prosthetics (12 decks)

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