DFU & STI

Question 1

What are the three main contributing factors to diabetic foot?

Answer 1

Neuropathy, infection, and ischemia.

Question 2

What types of neuropathy contribute to diabetic foot?

Answer 2

Sensory, motor, and autonomic.

Question 3

What are the features of sensory neuropathy?

Answer 3

Loss of proprioception, vibration, numbness, paresthesia.

Question 4

What is the key pathophysiology in motor neuropathy of diabetic foot?

Answer 4

Muscle wasting, foot deformity, clawing of toes.

Question 5

What is the role of autonomic neuropathy in diabetic foot?

Answer 5

Dry skin, cracks, loss of hair → injury risk.

Question 6

How does ischemia contribute to diabetic foot?

Answer 6

Poor blood flow due to macro- and microangiopathy.

Question 7

What is the first step in examining a diabetic foot ulcer?

Answer 7

Inspection: site, size, shape, surrounding tissue, smell.

Question 8

What are the 5S in DFU description?

Answer 8

Site, size, shape, surrounding tissue, smell.

Question 9

How is DFU sensation tested?

Answer 9

Cotton, pin-prick, monofilament test.

Question 10

What are common toe deformities in DFU?

Answer 10

Claw toe, hammer toe, mallet toe.

Question 11

What classification systems are used for DFU?

Answer 11

Wagner classification.

Question 12

What is a differential diagnosis of DFU without ulcer?

Answer 12

Foot cellulitis.

Question 13

What blood investigations are needed for DFU?

Answer 13

FBC, renal profile, RBS, CRP, culture and sensitivity.

Question 14

What imaging is used in DFU?

Answer 14

Foot X-ray (AP & lateral), chest X-ray, ECG.

Question 15

What is ABSI and its normal range?

Answer 15

Ankle Brachial Systolic Index; 0.9–1.2.

Question 16

What are ED management steps for DFU?

Answer 16

Analgesia, antibiotics, IV drip, wound dressing, admit, control sugar.

Question 17

When should surgery be planned for DFU?

Answer 17

If debridement or amputation is needed.

Question 18

What are discharge criteria for DFU?

Answer 18

No pain, ambulatory, good sugar control, healthy wound.

Question 19

What advice is given to high-risk diabetic foot patients?

Answer 19

No barefoot, daily inspection, moisturise, proper footwear.

Question 20

Why should diabetic shoes be bought in the evening?

Answer 20

Feet swell to maximum size by then.

Question 21

What is Charcot foot?

Answer 21

Progressive destruction of foot joints due to neuropathy.

Question 22

How is Charcot foot classified?

Answer 22

Sanders and Frykberg Classification.

Question 23

What imaging supports Charcot foot diagnosis?

Answer 23

X-ray, MRI.

Question 24

What is the initial management of acute Charcot foot?

Answer 24

Total contact cast and offloading.

Question 25

What is the surgical goal in Charcot foot?

Answer 25

Create stable, plantigrade foot.

Question 26

What is a furuncle?

Answer 26

Tender subcutaneous nodule from folliculitis, often S. aureus.

Question 27

What is a carbuncle?

Answer 27

Deep, interconnected furuncles draining pus, often with fever.

Question 28

Management of carbuncle?

Answer 28

Saucerization and systemic antibiotics.

Question 29

What is cellulitis?

Answer 29

Infection of deep dermis and subcutaneous tissue.

Question 30

Management of mild cellulitis?

Answer 30

Oral cephalexin.

Question 31

Severe cellulitis treatment?

Answer 31

IV ampicillin/sulbactam.

Question 32

What is necrotising fasciitis?

Answer 32

Rapid necrosis of fascia and subcutaneous tissue.

Question 33

Key clinical sign of necrotising fasciitis?

Answer 33

Wooden-hard feel, crepitus, dishwater discharge.

Question 34

What is LRINEC score used for?

Answer 34

Assessing necrotising fasciitis.

Question 35

Management of necrotising fasciitis?

Answer 35

Urgent fasciectomy, debridement, antibiotics.

Question 36

What is purpura fulminans?

Answer 36

Acute purpuric rash with skin necrosis and microvascular coagulation.

Question 37

What is gas gangrene?

Answer 37

Clostridial myonecrosis with gas in tissue.

Question 38

Gas gangrene presentation?

Answer 38

Fever, sepsis, crepitus, foul-smelling brown discharge.

Question 39

Gas gangrene management?

Answer 39

Urgent surgery, penicillin + clindamycin, hyperbaric oxygen.

Question 40

What is dry gangrene?

Answer 40

Tissue dries, shrinks, and turns black due to ischemia.

Question 41

What is wet gangrene?

Answer 41

Infected necrotic tissue with swelling, foul smell.

Question 42

Key investigation in gangrene?

Answer 42

FBC, tissue culture, imaging.

Question 43

What is rheumatoid arthritis?

Answer 43

Chronic inflammatory disease of small joints.

Question 44

RA clinical features?

Answer 44

Morning stiffness ≥60 mins, symmetrical joint swelling.

Question 45

RA deformities?

Answer 45

Swan-neck, boutonniere, Z-thumb, ulnar deviation.

Question 46

Key RA investigation?

Answer 46

CRP, ESR, RF, anti-CCP.

Question 47

RA management?

Answer 47

DMARDs, NSAIDs, corticosteroids.

Question 48

What is tuberculous arthritis?

Answer 48

Chronic granulomatous joint infection by Mycobacterium tuberculosis.

Question 49

Common TB arthritis symptoms?

Answer 49

Joint swelling, stiffness, fever, weight loss.

Question 50

TB arthritis investigations?

Answer 50

X-ray, ESR, synovial fluid AFB, biopsy.

Question 51

Management of TB arthritis?

Answer 51

Rest, splintage, anti-TB drugs, surgical drainage.