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28 Cards in this Set
- Front
- Back
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What are the main 3 types of wounds encountered in primary care/hospitilist medicine?
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-venous stasis ulcers
-diabetic foot ulcers -decubitus (pressure) ulcers |
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What are some risk factors for venous stasis ulcers?
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-obesity
-prolonged standing -CHF -pregnancy -trauma -vascular sx -DVT -faulty/incompetent venous valves -dependent edema/venous HTN -chonic skin changes -minor trauma -ulcers |
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What are some risk factors for diabetic foot ulcers?
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deformity + minor trauma + impaired vision + impaired circulation + reduced immune response
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What are the intrinsic risk factros for decubitus ulcers?
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-elderly skin changes
-immobility -poor circulation -poor nutrition -incontinence -neurological deficit |
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What are some extrinsic risk factors for the development of decubitus ulcers?
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-pressure/soft tissue compression over bony prominences
-shearing forces -friction and moisture -disrupted capillary supply of oxygen and nutrients -localized areas of tissue destruction over boney prominences |
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What are some S/S of venous stasis ulcers?
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-edema
-vircose veins -pruritis -eczema -red brown pigmentation form extravasation of RBC -lipodermatoscerosis -aching -usually normal pressure |
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What are some S/S of diabetic foot ulcers?
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-often on plater surface
-2nd metatarsal head -decreased distal sensation -decreased pedal pulses |
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Peripheral atrerial disease ulcers are often associated with what things?
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-pain with exercise
-decreased pulses -cool skin temp -shiny hairless skin in a smoker iwth HTN and dyslipidemia |
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What are 8 things you want to describe when telling someone about an ulcer?
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-size
-location -depth -appearance -exudate/odor -sinus tract formation -undermining of margins -dissection to bone-using sterile blunt probe |
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A monfilament test is used for what?
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distal sensation
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Why would you do a venous duplex ultrasound?
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screen for venous disease
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Why would you do an ankle brachial index?
What is normal, minimal, and significant |
-to screen for peripheral arterial disease
-normal is 1 -minimal 0.9 -significant 0.5-0.8 |
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What are some other tests/labs you can run in ulcers?
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-tissue culture
-albumin/prealbumin -plain film or MRI for osteomyelitis |
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What are some treatment specific to venous stasis ulcers?
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-weight loss
-elevate legs -gradient compression stockings -walking -avoid prolonged sitting or standing -treat edema -Unna boots -skin grafts in unresponsive cases |
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What are some treatments specific to diabetic foot ulcers?
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-dialy inspection
-wear white socks -debridement of calluses an ingrown toenails -pressure relieve in shoot orthotics -normalization of blood glucose -off loading (what ever that is?) |
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What are some treatments specific to decubitus ulcers?
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-educate caregivers
-frequent inspections -repsitioning q 2 hrs -trapese bar for pt -lower head of bed to lowest level wihtout compromsing other conditions -pressure reducing devices -nutrition consult -decreasing moisture |
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Wound healing depends on what things?
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-good nutrition
-good circulation -reduction of pressure -viable tissue -control of edema -consider multidisciplinary approach |
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Increasing what in the diet can help with tx of ulcers?
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-protein
-vit c -zinc |
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Stop _____, and normalizing ______ ______ can also help with tx of ulcers?
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-stop smoking
-normalize blood glucose |
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Debridement and _________ can also help with the tx of ulcers?
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debridement and irrigation
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What topical abx is good for the tx of ulcers?
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silver sulfadiazine
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Name 4 other tx that can be used for ulcers?
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-wet to dry dressings-saline soaked gauze
-wound care specialist consult -vascular sx consult if ischemia is involved -skin grafts |
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What is becaplermin, that can be used for ulcer tx?
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-platelet derived growth factor
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What is human fibroblasts that can be used to rx ulcers?
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dermagraft from neonatal foreskin
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What is Alginate that can be used for the tx of ulcers?
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-seaweed sheets or ropes that absorb exudates
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What is hydrocolloid that can be used for ulcer tx?
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-wafer dressing that interacts with wound exudate to from moist gell on wound beds
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Foams and hydrogel can also be used for the tx of ulcers>
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just so you know
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What are some sequela to ulcers?
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-cellulitis
-baceremia -sepsis -osteomyelitis -amputations |
