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
2
Q
Features of osteomyelitis
A
- Pain - unable to weight bear
- Erythematous
- Swollen
- Fever
- Drainage - sinus tract/abscess
- Bacteraemia?
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
4
Q
Plain radiograph signs of osteomyelitis
A
- Cortical bone loss
- Osteopenia
- Periosteal thickening
- Endosteal scalloping
- Soft tissue swelling
COPES
5
Q
Classifying diabetic ulcer
A
SINBAD
* Site
* Ischaemia
* Neuropathy
* Bacteria
* Area
* Depth
6
Q
Common organisms involved in diabetic foot ulcer
A
- Staphylococcus aureus
- Escherichia coli
- Pseudomonas aeruginosa
7
Q
Common abx used for infected diabetic ulcer
A
- Flucloxacillin/Clarithromycin/Doxycycline/Gentamicin
- Co-amoxiclav
- Metronidazole
- Co-trimoxazole
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
9
Q
What are steps involved in ulcer healing?
A
- Offloading - non-removable casting
- Control infection
- Control ischaemia
- Debridement
- Dressings
10
Q
A