Case 4 - Foot problem Flashcards

1
Q

Cause of diabetic foot ulceration

A
  • Diabetic peripheral neuropathy = not feeling injury
  • Poor healing due to lack of perfusion
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2
Q

Features of osteomyelitis

A
  • Pain - unable to weight bear
  • Erythematous
  • Swollen
  • Fever
  • Drainage - sinus tract/abscess
  • Bacteraemia?
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3
Q

Investigations for osteomyelitis

A
  • FBC
  • ESR and CRP
  • Blood cultures
  • X-ray - if needed MRI/CT PET?
  • Bone samples + biopsy –> culture - gold standard
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4
Q

Plain radiograph signs of osteomyelitis

A
  • Cortical bone loss
  • Osteopenia
  • Periosteal thickening
  • Endosteal scalloping
  • Soft tissue swelling

COPES

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5
Q

Classifying diabetic ulcer

A

SINBAD
* Site
* Ischaemia
* Neuropathy
* Bacteria
* Area
* Depth

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6
Q

Common organisms involved in diabetic foot ulcer

A
  • Staphylococcus aureus
  • Escherichia coli
  • Pseudomonas aeruginosa
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7
Q

Common abx used for infected diabetic ulcer

A
  • Flucloxacillin/Clarithromycin/Doxycycline/Gentamicin
  • Co-amoxiclav
  • Metronidazole
  • Co-trimoxazole
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8
Q

Multidisciplinary team involved in diabetic foot care

A
  • Diabetiologist/endocrinolgist
  • GP
  • Diabetic nurses
  • Podiatry - foot protection service
  • Wound care nurse
  • Surgeons - severe deformites
  • Radiologists
  • Dieticians
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9
Q

What are steps involved in ulcer healing?

A
  • Offloading - non-removable casting
  • Control infection
  • Control ischaemia
  • Debridement
  • Dressings
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10
Q
A
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