Vascular Disorders (2)

Question 1

What is a diabetic foot?

Answer 1

Infection, ulceration, or destruction of deep tissues associated with neurological abnormalities and various degrees of peripheral vascular diseases in the lower limb

Question 2

What is 40-60% of all non traumatic lower limb amputation caused by?

Answer 2

Diabetic foot

Question 3

What are 85% of diabetic related foot amputation preceded by?

Answer 3

Foot ulcer

Question 4

What are 4 out of 5 ulcers in diabetics precipitated by?

Answer 4

Trauma

Question 5

What is the prevalence of foot ulcers in diabetics?

Answer 5

4-10%

Question 6

What percentage of patients with type 2 diabetes have significant neuropathy?

Answer 6

50% (also at risk for foot ulcer)

Question 7

What are major risk factors for a foot ulcer?

Answer 7

Sensorimotor and peripheral sympathetic neuropathy

Question 8

What is the history of peripheral vascular disease?

Answer 8

Claudication that is relieved by rest

Question 9

What would palpating a foot feel like in someone with peripheral vascular disease?

Answer 9

Cold

Question 10

What pulses are examined in someone with peripheral vascular disease?

Answer 10

Dorsalis pedis and posterior tibial

Question 11

Reactive hyperemia

Answer 11

Leg turns bright red when going from an elevated position to declining back to the ground

Question 12

What is the monofilament test used for?

Answer 12

To test for neuropathy

Question 13

What is known as the most important pre-ulcerative lesion stage?

Answer 13

Callus (removed by professional)

Question 14

How should dry skin and fissure be treated?

Answer 14

With an emollient (reduce fissure margins with scalpel)

Question 15

What are the stages of an ulcer development?

Answer 15

Callus formation

Subcutaneous hemorrhage

Breakdown of skin

Deep foot infection with osteomyelitis

Question 16

What is neurogenic arthropathy?

Answer 16

Rapidly progressive degenerative arthritis that results from damaged nerves

Question 17

What is another name for neurogenic arthropathy?

Answer 17

Charcot foot

Question 18

What is severely impaired in Charcot foot?

Answer 18

Pain perception

Motor function

Proprioception of the foot

Question 19

What does a loss of the motor and sensory functions in Charcot foot cause?

Answer 19

Minor traumas to go undetected leading to laxity, dislocations, bone erosions, cartilage damage, and deformity of the foot

Question 20

What is the most common cause of Charcot foot?

Answer 20

Diabetes (60-70%)

Question 21

When does the onset of Charcot foot occur?

Answer 21

When a patient has had diabetes for 15-20 years usually older than 50

Question 22

What is an intervention for Charcot foot?

Answer 22

Total contact casting

Question 23

What are the 5 pillars to prevent foot problems in diabetes?

Answer 23

Identification of high risk patient

Regular inspection and exam of foot and foot wear

Education of patient, family and health care providers

Appropriate foot wear

Treatment of non ulcerative pathology