start Flashcards
1
Q
onychotilmania
A
compulsive nail biting
2
Q
leukonychia
A
white nails
3
Q
haematoma
A
bruise on nail
4
Q
melanonychia
A
cancer on nail
5
Q
onychomycosis
A
fungal nail
6
Q
beau’s lines
A
transverse nail grooves
7
Q
onychophosis
A
callus in sulcus
8
Q
onychatrophia
A
mature nail regressing partially or completely
9
Q
pterygium
A
matrix disorder where eponychium is attached to the nail bed
10
Q
pnychocryptosis
A
IGTN
11
Q
hippocratic
A
club nails
12
Q
koilonychia
A
spoon shaped nails: iron deficiency
13
Q
AAFFD stands for?
A
adult acquired flat foot deformity
14
Q
PRN
A
review as necessary
15
Q
kohlers?
A
avascular necrosis of navicular
16
Q
what would a patient complain of if they had a morton’s neuroma?
A
burning, radiating foot pain
17
Q
freiburg infaction
A
avascular necrosis of the condyle (2nd met head), which occurs from repetitive stress with microfracture . sometimes loose bodies are seen in radographs
18
Q
MODA
A
mature onset of diabetes of the young
19
Q
What is HK, what is its aetiology and predisposing factors?
A
Hypertrophy of corneum,
Aetiology: compression, tensile, friction, shearing,
Predisposing factors: biomechanical abnormalities, hard walking surfaces, poor footwear, fat pad atrophy
20
Q
rubor
A
redness
21
Q
calor
A
heat
22
Q
turgor
A
swelling
23
Q
dolor
A
pain
24
Q
How do verrucae form, what is the classification and rx.
A
benign growth caused by papillomaviruses of the HPV group
Vulgaris, arida, humida, mosaic
Rx. : nothing, salicylic acid
25
Psoriasis:
Periodic flare ups, AI, high cell turnover,
Types: plaque, guttate, inverse, pustular,
Rx. coal tar, UV, methotrexate
26
What is reiter’s?
Congunctivitis
Urethritis
Arthritis
27
What are the risk factors for plantar melanomas?
High total naevi body count
Pre-existing naevi on soles
Hx penetrating injury
Exposure to agricultural chemicals
28
What the ABCDE of malignancy assessment?
```
Asymmetry
Border irregularity
Colour
Diameter
Elevation
```
29
Plantarfasciitis
```
Insidious onset
First step pain
Inflammation of PF
Seen in combination with tight gastrocs
Rx. RICE, stretching, orthotics, taping, decrease irritation, extracorporeal shockwave therapy, surgery
```
30
Differentiate between type 1 and type 2 diabetes:
AI, beta cells in the pancreas are destroyed by T cells. Reduced insulin secretion. Treat with insulin
Lifestyle related, polyuria. Polydipsia, lack of energy blurred vision weight gain, frequent infections, ulcers/slow healing, itching, skin infections, headaches, leg cramp
31
what do results mean in diabetes?
```
What are good results in diabetes?
Random BG: 4-11 mmol/l
FMG: > 7 mmol/l is bad
2 hour post prandial > 11 mmol is bad
HbA1c>6.5% is bad
```
32
what fractures can occur on the 5th ray
- avulsion
- jones
- stress
- iselin disease/iselin's apophysitis (avulsion in growth plate age)
33
dx. criteria for RA
```
Morning stiffness
3 or more joints
Hands first
Symmetrical
Rhematoid nodules
Serum rhematoid
Radiographic changes
```
34
what changes would we see in a foot with RA?
```
Joint stiffness and pain
Downward displacement and splaying of the forefoot
Cock up toes
Lateral shift of toes
Contracture of extensor tendons
Nodules appearing
Callosity and bursa development
HAV
Nerve entrapment
Round foot of rheumatism
```
35
clinical features of gout
First attack involves 1st metatarsophalangeal joint
Excruciating pain in big toe
Sudden onset. Instantly debilitating
Untreated attack lasts for 7 days
Further joints become involved e.g. elbows, hands
Tophi may develop
36
What is the funciton of the plantarfascia?
Assist in propulsion and resupination
Stiffens with increasing load
Stores elastic energy to act as a shock absorber
-resupination of the foot propulsion
37
What connective tissue conditions that plantarfasciitis is associated with?
RA
Ankylosing spondylitis (an inflammatory arthritis that mostly affects the spine
Psoriatic arthritis
Hyperthermia
38
what is ddx. Of plantarfasciitis
Joggers heel, policeman’s heel, calcaneal bursitis, fat pad rupture, stone bruise, calcaneal stress #, neuroma, severs disease, tumor, calcaneal enthesopathy
39
What is calcaneal enthesopathy?
Pain at insertion of achilles tendon (found on google)
compression/friction due to dysfunction of the calcaneal fat pad causing thickening of the enthesis. Can be inflammatory, degenerative, endocrine, metabolic, traumatic. considered problematic if more than 4 mm thick on sonogram
40
How would you manage calcaneal enthesopathy?
Activity modification, footwear changes, stretching of PF and triceps surae, cryotherapy (cold), myofascial trigger points/deep tissue massage, mobilisation, dry needling, taping
41
How does a low-dye taping unload the pfascia
Inverts the RF
Everts th FF
Plantarflexes the 1st ray
Supports the arch
42
What question would you ask for each letter in NOLDCAT?
Nature: pain, pressure, burning itching, stabbing, throbbing, aching
Onset: when do they occur i.e. when does it become painful? All the time? When walking? When resting?
Location
Duration of sx- how loing has it been there? Weeks, ? months? Recurring?
Cause Do they have any idea on what, why and where it started?
Amelioration : is there anything that makes the problem get better? Or makes it worse?
T: what previous rx have you had?
43
what does the ABI assess?
The ratio between the brachial BP and the ankle BP. not reliable in diabetes due to calcification of vessels
44
what is the best topical antifungal?
terbinafine
45
what rx do you use for dry skin on feet e.g. heel fissures
urea: breaks down keratin, allowing moisture to penetrate 2.5%.
46
what do you call the blue stuff you wrap the instruments in for sterilising?
kim guard
47
what is onychomadesis?
regression from proximal not distal end
48
what are some questions you could ask someone with diabetes?
- what type of diabetes
- duration of diabetes
- blood glucose control mechanism
- what last blood glucose reading was incl. HbA1c
- what other health professionals they see
- level of knowledge about foot care and diabetes
49
where is the DP pulse?
between the tendons of EHL and EDL over the top of the navicular
50
what sight/smell would pseudamonas make?
green, foul
51
what sight/smell would s. epidermidis make?
white, fruity
52
list (in order of 1st line 2nd line etc.) the drugs used to treat T2DM also pls give an e.g. of each
1. biguanides: e.g. metformin
2. sulphonylureas e.g. glicazide
3. thiazolidenediones/glitazones: e.g. rosiglitazone
4. alpha glucoside inhibitors: e.g. arcabose
5. DPP4 inhibitors: e.g. sitagliptin
6. incretin mimetics: e.g. exenatide
7. SGLT2 inhibitors: e.g. canagliflozin
53
list sx. of DVT
- difference in colour and skin temp
- will be read and warm
- painful lef esp. in calf
- swelling and inflammation of area --> looks almost like an infection
- pain when DF foot maybe
- any long travel in general e.g. flight/bus/car
- pitting oedema at AJ due to leaky vessels
- unilateral
54
how do we dx. a suspected DVT?
- D-dimer blood test
| - ultrasound (will only show up 3-7 days after event)
55
advice to pt. with suspected DVT?
- go to GP or emergency ASAP for further diagnostic testing and assessment
56
what is the typical management of a pt. with DVT?
anticoag approx. 12 months
heparin/warfaring
these drugs reduce clotting time (i.e. are blood thinners) so consider that!
compression stocking for flights as prevention
57
risk factors of Osteoporosis
- female
- post menopause
- kyphosis is commonly seen as it is caused by spinal fractures leading to compression
- smoking/alcohol
- meds: corticosteroids, thyroid hormone replacement, SSRIs, thiazolidenediones (DM), certain anti-epileptics,
- low activity levels/immobility
- fam hx. of hip #
58
what drugs are used for osteoporosis?
bisphosphonates e.g. zolendronic acid
59
what footwear considerations would you have for a patient with osteoporosis?
- stability to decrease falls risk
- extra padding because fragile bones + fat pad atrophy increase risk of stress fracture
- as light weight as possible
- orthotics probs not appropriate esp. in uncomplicated situation and no real need
60
what are some sx. of osteoporosis?
- #s, height loss, weight loss, LBP (lower back pain}), lower BMD
- stress # very common and easily missed
61
how do dx. stress fracture?
ultrasound is best. x-ray probs won't show it if its fresssh
62
what is charcot marie tooth?
- genetic NM disorder causing nerve damage
- demyelinating
- progressive
- heterogenous
- more common in males
63
what will we see with a charcot marie tooth? CMT
- high arch/supinated foor type
- hammer toes
- drop foot
- mm wasting
- progressive
-reduced proprioception sensation
affects gait massively
pressure lesions and then ulcers common
- increase risk of inversion sprains
64
what would you do for a pt. with CMT charcot marie tooth?
- wound care
- paddings and offloading of wounds
- orthoses need to be accomodative as opposed to corrective
- refer to surgeon if needed
- OT, physio, falls clinic
65
what other issues can CMT cause?
- issues with breathing
| - doesnt really shorten lifespan but can be disabling and make life a bit tricky
66
what are risk factors of plantarfasciitis?
- BMI 25 +
- AJ DF <10 deg
WB occupation
diabetes
67
what ligament is most likely to be affected in an inversion ankle sprain?
ant talo fib
68
what is a "drawer test"
when you wiggle the metatarsal and toe to see if there is excessive ROM. if there is heaps of ROM that suggests plantar plate tear
69
what is the difference between onychocryptosis and paronychia?
onychocryptosis is the term given for when the nail grows inwards.
paronychia is the term for if that area gets infected
70
what affects skin integrity?
- neuropathy stops sweat
- hx, of skin tears,
- dry skin/dehydration
- fragile
- steroids
- corticosteroids topically
- allergies
- vascular status
- gender
- if they are hella sweaty
71
what's the name of the white tape that we keep near the sports tape?
micropore surgical tape
72
what are subjective informations we collect from our patients regularly
1. presenting complaint
2. medical hx.: other conditions, past medical/surgery, fam hx.
3. medications
4. social hx.
5. funcitonal assessment
6. exercise
7. footwear, orthoses/insoles/mobility aids
8 other health professionals seen regularly
73
what logistical information do we collect from our patients?
name, address, DOB, contact #, email
- doctor
- emergency contact
- allergies alert
- medical alert
- other considerations: interpreter, access, cultural
