Diabetic Foot and Gangrene1 Flashcards Preview

Cameron Vascular > Diabetic Foot and Gangrene1 > Flashcards

Flashcards in Diabetic Foot and Gangrene1 Deck (23)
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1
Q

MCC of amputation

A

type 2 diabetes

2
Q

Primary screening evaluation for diabetic foot

A

ABI�s

3
Q

Why are radiographs needed in a diabetic foot

A

look for Charcot bone and joint destruction

4
Q

If a patient presents with plantar ulceration of the sole of the foot what else should you look for

A

tarsal cuboid collapse

5
Q

What does stage 1 of the surgical process consist of when dealing with a diabetic foot

A

deep, wide resection, excise all necrotic tissue

6
Q

Should cultures be sent during stage 1 surgical debridement for diabetic foot

A

yes

7
Q

What does stage 2 consist of for surgical tx of a diabetic foot

A

debridement (+or- amputation) and pulsatile irrigation, deep cultures, delayed primary closure

8
Q

Define gangrene

A

critical limb ischemia, infection or any process causing arterial occlusion

9
Q

RF’s for gangrene of the foot

A

DM, smoking, CKD

10
Q

How is the level of amputation assessed by physical exam

A

skin temp or color, muscle atrophy, presence of proximal pulses

11
Q

What ABI value indicates poor wound healing

A

less than 0.4

12
Q

What disease may falsely elevate an ABI

A

diabetes

13
Q

What causes an elevated ABI in DM

A

arterial calcification

14
Q

What is a common ABI in patients with DM

A

greater than 1.4

15
Q

How does toe-brachial index measure arterial calcification

A

photoplethysmography

16
Q

What imaging can be done to diagnose critical limb ischemia

A

digital subtraction angio, MAR, CTA

17
Q

What is the gold standard to dx critical limb ischemia

A

angiography

18
Q

What are the MC organisms found in gangrene

A

gram-positive, gram-negatives, anaerobes

19
Q

Which bacteria are more likely to thrive in a diabetic foot

A

gram positive cocci (Staph aureus, B-hemolytic Strep)

20
Q

What procedures are preferred for short segment occlusions vs long segment occlusion

A

short: endovascular or percutaneous intervention; long:bypass

21
Q

Why are amputations performed in patients with gangrene

A

source control, preserve viable tissue

22
Q

How is energy expended in proximal vs distal amputations

A

exert more energy the more proximal the amputation

23
Q

What benefits does the great toe have

A

important for balance and gait