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Medicine

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Endocrine

Question
17 out of 33
 

Risk factor for diabetes foot is:



A Male
B Callus formation

C Diabetes >10 year
D All of the above

Ans. D All

(Ref: Hari 18th ed. Pg , 2982)

1). DM is the leading cause of nontraumatic lower extremity amputation.

2). Occurs due to ischaemia (absent dorsalis pedis pulses) and peripheral neuropathy (injury or infection over pressure points, eg the metatarsal heads).

3). Foot ulceration Usually painless, punched-out ulcer in an area of thick callus + superadded infection. Can lead to cellulitis, abscess and osteomyelitis. Great toe & MTP areas are most common site.

4). Microangiopathic changes in blood vessels in the form of peripheral arterial disease contribute to the generation of foot ulcers and non microangiopathic changes.

Risk factors for foot ulcers or amputation (Ref: Hari-18th ed. Pg , 2987)

1). Male sex

2). Peripheral neuropathy

3). Peripheral arterial disease

4). History of previous ulcer or amputation

5). Diabetes >10 years' duration

6). Abnormal structure of foot (bony abnormalities, callus, thickened nails)

7). Smoking

8). Poor glycemic control.

Extra Edge: Pathogenic Factors in generation of foot ulcers in DM

1). Neuropathy (Peripheral Sensory neuropathy): Trophic changes. Loss of Sensation (MCQ: vibration is the first to be lost) in gloves & 'stocking' distribution, absent ankle jerks, neuropathic deformity: pes cavus, claw toes, loss of Transvene arch, rocker-bottom sole.

2). Abnormal foot biomechanics (d/t disordered proprioception and sensorimotor neuropathy)

3). Peripheral arterial disease (Macroangiopathy) and poor wound healing

4). Autonomic neuropathy anhidrosis and altered superficial blood flow in foot)

5). Poor wound healing.

Extra edge:

1). Callus formation is the earliest manifestation of diabetic foot.

2). Frequency of the tuning fork used to assess vibration sense is 128).

Endocrine Flashcard List

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