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OSCE podiatry > start > Flashcards

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1
Q

onychotilmania

A

compulsive nail biting

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2
Q

leukonychia

A

white nails

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3
Q

haematoma

A

bruise on nail

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4
Q

melanonychia

A

cancer on nail

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5
Q

onychomycosis

A

fungal nail

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6
Q

beau’s lines

A

transverse nail grooves

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7
Q

onychophosis

A

callus in sulcus

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8
Q

onychatrophia

A

mature nail regressing partially or completely

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9
Q

pterygium

A

matrix disorder where eponychium is attached to the nail bed

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10
Q

pnychocryptosis

A

IGTN

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11
Q

hippocratic

A

club nails

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12
Q

koilonychia

A

spoon shaped nails: iron deficiency

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13
Q

AAFFD stands for?

A

adult acquired flat foot deformity

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14
Q

PRN

A

review as necessary

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15
Q

kohlers?

A

avascular necrosis of navicular

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16
Q

what would a patient complain of if they had a morton’s neuroma?

A

burning, radiating foot pain

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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

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18
Q

MODA

A

mature onset of diabetes of the young

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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

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20
Q

rubor

A

redness

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21
Q

calor

A

heat

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22
Q

turgor

A

swelling

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23
Q

dolor

A

pain

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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

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25
Q

Psoriasis:

A

Periodic flare ups, AI, high cell turnover,
Types: plaque, guttate, inverse, pustular,
Rx. coal tar, UV, methotrexate

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26
Q

What is reiter’s?

A

Congunctivitis
Urethritis
Arthritis

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27
Q

What are the risk factors for plantar melanomas?

A

High total naevi body count
Pre-existing naevi on soles
Hx penetrating injury
Exposure to agricultural chemicals

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28
Q

What the ABCDE of malignancy assessment?

A 
Asymmetry
Border irregularity
Colour
Diameter
Elevation
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29
Q

Plantarfasciitis

A 
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
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30
Q

Differentiate between type 1 and type 2 diabetes:

A

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
Q

what do results mean in diabetes?

A 
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
Q

what fractures can occur on the 5th ray

A
  • avulsion
  • jones
  • stress
  • iselin disease/iselin’s apophysitis (avulsion in growth plate age)
33
Q

dx. criteria for RA

A 
Morning stiffness
3 or more joints
Hands first
Symmetrical
Rhematoid nodules
Serum rhematoid
Radiographic changes
34
Q

what changes would we see in a foot with RA?

A 
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
Q

clinical features of gout

A

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
Q

What is the funciton of the plantarfascia?

A

Assist in propulsion and resupination
Stiffens with increasing load
Stores elastic energy to act as a shock absorber
-resupination of the foot propulsion

37
Q

What connective tissue conditions that plantarfasciitis is associated with?

A

RA
Ankylosing spondylitis (an inflammatory arthritis that mostly affects the spine
Psoriatic arthritis
Hyperthermia

38
Q

what is ddx. Of plantarfasciitis

A

Joggers heel, policeman’s heel, calcaneal bursitis, fat pad rupture, stone bruise, calcaneal stress #, neuroma, severs disease, tumor, calcaneal enthesopathy

39
Q

What is calcaneal enthesopathy?

A

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
Q

How would you manage calcaneal enthesopathy?

A

Activity modification, footwear changes, stretching of PF and triceps surae, cryotherapy (cold), myofascial trigger points/deep tissue massage, mobilisation, dry needling, taping

41
Q

How does a low-dye taping unload the pfascia

A

Inverts the RF
Everts th FF
Plantarflexes the 1st ray
Supports the arch

42
Q

What question would you ask for each letter in NOLDCAT?

A

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
Q

what does the ABI assess?

A

The ratio between the brachial BP and the ankle BP. not reliable in diabetes due to calcification of vessels

44
Q

what is the best topical antifungal?

A

terbinafine

45
Q

what rx do you use for dry skin on feet e.g. heel fissures

A

urea: breaks down keratin, allowing moisture to penetrate 2.5%.

46
Q

what do you call the blue stuff you wrap the instruments in for sterilising?

A

kim guard

47
Q

what is onychomadesis?

A

regression from proximal not distal end

48
Q

what are some questions you could ask someone with diabetes?

A
  • 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
Q

where is the DP pulse?

A

between the tendons of EHL and EDL over the top of the navicular

50
Q

what sight/smell would pseudamonas make?

A

green, foul

51
Q

what sight/smell would s. epidermidis make?

A

white, fruity

52
Q

list (in order of 1st line 2nd line etc.) the drugs used to treat T2DM also pls give an e.g. of each

A
  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
Q

list sx. of DVT

A
  • 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
Q

how do we dx. a suspected DVT?

A
  • D-dimer blood test

- ultrasound (will only show up 3-7 days after event)

55
Q

advice to pt. with suspected DVT?

A
  • go to GP or emergency ASAP for further diagnostic testing and assessment
56
Q

what is the typical management of a pt. with DVT?

A

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
Q

risk factors of Osteoporosis

A
  • 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
Q

what drugs are used for osteoporosis?

A

bisphosphonates e.g. zolendronic acid

59
Q

what footwear considerations would you have for a patient with osteoporosis?

A
  • 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
Q

what are some sx. of osteoporosis?

A
  • # s, height loss, weight loss, LBP (lower back pain}), lower BMD
  • stress # very common and easily missed
61
Q

how do dx. stress fracture?

A

ultrasound is best. x-ray probs won’t show it if its fresssh

62
Q

what is charcot marie tooth?

A
  • genetic NM disorder causing nerve damage
  • demyelinating
  • progressive
  • heterogenous
  • more common in males
63
Q

what will we see with a charcot marie tooth? CMT

A
  • 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
Q

what would you do for a pt. with CMT charcot marie tooth?

A
  • 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
Q

what other issues can CMT cause?

A
  • issues with breathing

- doesnt really shorten lifespan but can be disabling and make life a bit tricky

66
Q

what are risk factors of plantarfasciitis?

A
  • BMI 25 +
  • AJ DF <10 deg
    WB occupation
    diabetes
67
Q

what ligament is most likely to be affected in an inversion ankle sprain?

A

ant talo fib

68
Q

what is a “drawer test”

A

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
Q

what is the difference between onychocryptosis and paronychia?

A

onychocryptosis is the term given for when the nail grows inwards.
paronychia is the term for if that area gets infected

70
Q

what affects skin integrity?

A
  • neuropathy stops sweat
  • hx, of skin tears,
  • dry skin/dehydration
  • fragile
  • steroids
  • corticosteroids topically
  • allergies
  • vascular status
  • gender
  • if they are hella sweaty
71
Q

what’s the name of the white tape that we keep near the sports tape?

A

micropore surgical tape

72
Q

what are subjective informations we collect from our patients regularly

A
  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
Q

what logistical information do we collect from our patients?

A

name, address, DOB, contact #, email

  • doctor
  • emergency contact
  • allergies alert
  • medical alert
  • other considerations: interpreter, access, cultural

OSCE podiatry (6 decks)

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