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Year 2 Endocrine > The diabetic foot > Flashcards

The diabetic foot Flashcards

1
Q

what are the three main starting points for diabetes induced arthropathy?

A
  • peripheral vascular disease
  • autonomic neuropathy
  • peripheral neuropathy
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2
Q

what is charcot?

A

deformed foot

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3
Q

arterial occlusion in diabetic arthropathy usually involves which arteries?

A

tibial

peroneal

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4
Q

what are the contributing factors to peripheral vascular disease?

A

smoking
hypertension
hyperlipidemia

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5
Q

what are the metabolic syndrome criteria?

A
  • hyperinsulinemia or hyperglycemia
  • hypertriglyceridemia
  • hypertension
  • obesity
  • increased CRP and hyperuricemia
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6
Q

what % of diabetics over 50 have PVD?

A

30%

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7
Q

signs and symptoms of arterial occlusive disease

A
  • claudication
  • rest pain
  • atrophic, shiny skin
  • diminished hair growth
  • dependent rubor
  • pallor on elevation
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8
Q

ankle brachial index equation

A

ABI = lower extremity systolic / brachial artery systolic

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9
Q

what are the ABI values in normal, mild, moderate, and severe obstruction?

A

normal - above 0.9
mild - 0.8-0.9
moderate - 0.5-0.8
severe - below 0.5

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10
Q

how does calcification affect ABI readings in diabetics?

A

falsely elevated

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11
Q

what is the normal appearance of doppler wave form?

A
  • triphasic
  • bidirectional
  • rapid upstroke / downstroke
  • flow reversal
  • arterial wall rebound
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12
Q

what is lost in mild / moderate / severe obstruction doppler wave forms?

A
  • decreasing / loss of peak height
  • absent flow reversal
  • absent elastic rebound
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13
Q

what does transcutaneous oxygen pressure measure?

A

partial oxygen tension on skin surface

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14
Q

what are the motor complications of peripheral neuropathy?

A
  • atrophy of intrinsic muscles
  • flexion deformity
  • pressure at metatarsal heads and toes
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15
Q

what are the autonomic complications of peripheral neuropathy?

A
  • dyshidrosis and dry skin

- AV shunting (increase in bone and skin perfusion)

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16
Q

what are the two pathophysiology models for charcot athropathy?

A

neurotraumatic

neurovascular

17
Q

what is the definition / etiology / result of neurotraumatic model of charcot arthropathy?

A
  • cause: exaggerated overuse injury coupled with loss of protective sensation
  • etiology: acute trauma or repetitive microtrauma
  • result: lack of sensation allows continued tissue destruction resulting in fractures and dislocations
18
Q

what is the definition / etiology / result of neurovascular model of charcot arthropathy?

A
  • cause: vasomotor neuropathy in patients with intact blood flow
  • etiology: AV shunting leads to excessive bone resorption and bone weakening
  • result: fractures and dislocations with continued weight bearing
19
Q

what are the stages of charcot?

A
  1. developmental
  2. coalescence
  3. reconstruction
20
Q

which grade of ulcer has exposed bone? what else is present?

A

grade 3

infection (osteomyelitis)

21
Q

which grade of ulcer has gangrenous changes of the forefoot? what treatment is required?

A

grade 4

debridement or amputation

22
Q

which grade of ulcer involves gangrene of the entire foot? what is the likely treatment?

A

grade 5

amputation

23
Q

which grade of ulcer has deeper lesions that have NOT penetrated to bone or a fascial plane?

A

grade 2

24
Q

which grade of ulcer consists of superficial lesions?

A

grade 1

25
Q

what is the best diagnostic test for arthropathy?

A

bone biopsy for histopathology and culture & sensitivity

26
Q

the pathophysiology of the development of infected foot ulcers in diabetic patients relates to what two factors?

A

neuropathy

ischemia

27
Q

what is one of the most serious problems of foot care in diabetic patients?

A

osteomyelitis

28
Q

which bone condition shows WBCs in the ceretec scan?

A

acute osteomyelitis

Year 2 Endocrine (33 decks)

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