Diabetic Foot Infections Flashcards

1
Q

What is the lifetime incidence of developing a DFU?

A

25%

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2
Q

what percentage of infected DFU will have underlying osteomyeitis?

A

20-68%

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3
Q

Name some risk factors for infection or ulceration.

A
  1. peripheral motor neuropathy
  2. peripheral sensory neuropathy
  3. autonomic neuropathy
  4. Neuro-osteoarthropic deformitis (i.e. Charcot)
  5. vascular insufficiency
  6. hyperglycemia
  7. patient disabilities
  8. maladaptive patient behavior
  9. healthcare system failure
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4
Q

how is infection clinically diagnosed?

A

presence of purulence

OR 2+ cardinal signs of inflammation

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5
Q

Classify this wound: wound without purulence or any manifestations of inflammation

A

uninfected

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6
Q

Classify this wound:

  • cellulitis or erythema 0.5cm-2cm around ulcer
  • infection is limited to skin or superficial subcutaneous tissue
A

mild

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7
Q

Classify this sound:
-erythema > 2cm or involving deeper structures than skin or subcutaneous tissue
AND no systemic inflammatory response syndrome (SIRS)

A

moderate

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8
Q

Classify this wound:

  • location infection w/ signs of SIRS as manifested by 2 of the following:
  • temp > 38 C
  • HR> 90bpm
  • RR > 20 breaths/min
  • PCO2 12,000
A

severe

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9
Q

which microorganisms are found in diabetic foot infections?

A

staph and strep

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10
Q

Name this bacteria: thick, yellow purulent drainage

A

MSSA

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11
Q

name this bacteria: deeper red infection than staph but not as purulent

A

strep

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12
Q

name this bacteria: fruity smell, green tinge to the wound

A

pseudomonas

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13
Q

Name this bacteria: extreme foul smell; brown, watery discharge

A

anaerobes

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14
Q

What ESR level and CRP indicates osteo?

A

ESR > 60
CRP > 3.2
along with ulcer >3mm

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15
Q

soft tissue infection is positive in which phases of Tc 99 bone scan ?

A

1st (immediate) and 2nd (blood pool) phase

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16
Q

bone infection is positive in which phases of Tc 99 bone scan?

A

all 3 phases

17
Q

deep abscess on MRI is best seen on which one?

A

T2

18
Q

when should you hospitalize a patient?

A
  • patient with critical limb ischemia
  • all severe infections
  • moderate infections requiring observation, urgent tests, or complicating factors
  • infections requiring surgery
19
Q

When should you do surgery/

A
  • life or limb threatening infection
  • evidence of abscess
  • severe infection with ischemia
  • osteomyelitis
20
Q

what is gold standard for diagnosis of osteomyelitis?

A

bone biopsy