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32 Cards in this Set
- Front
- Back
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T or F, most diabetic patients do not heal properly due to vascular reasons?
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False, pecoraro study showed only 10% were vascular, most had neuropathic problems that allowed minor trauma>ulcer>faulty healing and amputation
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The single most risk factor for developing foot ulceration is?
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Loss of protective sensation
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Why is NIDDM not a good acronym for type II diabetes?
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Some patients with type II actually require insulin
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Type 1 diabetes is also known as?
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Juvenile onset diabetes and accounts for only 5% of diabetes diagnosis
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Fasting plasma glucose greater or equal to ______
signifies diabetes as well as a a random plasma glucose of greater than or equal to _______ |
126mg/dL
200mg/dL |
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Pre-diabetes fasting and random plasma glucose ranges are?
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Fasting = between 100mg/dL and 126mg/dL
Random = between 140mg/dL and 200mg/dL |
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4 main risk factors for developing type II diabetes?
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obesity (central obesity especially)
family hx (1st degree relative) habitual physical inactivity age |
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T or F, metabolic syndrome is a problem with insulin resistance and hypoinsulinemia?
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False, hyperinsulinemia
b/c your not able to uptake insulin, your body overproduces insulin leading to high amts of glucose in the blood, eventually the insulin runs out |
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T or F, increased insulin resistance and reduced beta production of insulin occurs the older we get?
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true
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Explain Advanced Glycation End products or AGE's
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Hyperglycemia alters the structure and function of
protein; causing the cross-linking and thickening of protein molecules Even modest hyperglycemia results in the significant accumulation of AGEs |
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This occurs with an uptake of glycosulated LDL, a thickening and stiffening in the VESSEL WALL and an accelerated atherosclerosis
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Macroangiopathy
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This is associated with a thickening of the CAPILLARY basement membrane and CAPILLARY occlusion especially in the kidney, retina and microvasculature of peripheral nerves
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Microangiopathy
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Microvascular disease can lead to?
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to polyneuropathy, kidney failure, blindness and inhibits the access of phagocytic cells and antibiotics to sites of infection
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Cross-linking of periarticular collagen proteins caused by AGE's leads to?
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joint stiffness and limited joint mobility
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HbA1c is a measure of what?
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glycated hemoglobin
tells the physician how well the pt has controlled blood sugar over 3 months good glycemic control = HbA1c < 6.5% |
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Nonlocalizing foot pain (burning, especially at rest or at night)
Loss of sensation (insidious (pt’s don’t realize, distal, progessive) Dry skin Muscle weakness “Nonantalgic” gait Deformity (such as claw toes, foot drop) and Loss of balance are all signs of? |
Neuropathy in the foot
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_______is the primary factor in diabetic foot ulceration.
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sensory loss
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The normal foot should be able to feel a _____gram filament
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1 gram
can't feel 10gram, at risk for ulcers |
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Name 3 mechanisms of injury for the insensate foot:
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Single High Stress
Constant Low Stress Repetitive Stress Infection Heat/Cold/Chemical |
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When bed rest causes a pressure sore or one toe hits the other in a tight shoe, this is an example of?
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constant low stress
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If you notice layers of callus around a foot wound, what is probably the mechanism of injury?
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repetitive walking stress
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T or F, infection causes ulcers?
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False, ulcers get deeper and develop osteomylitis b/c of infection but its not the cause
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Foot ulcerations occur over areas of _______________.
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highest pressure
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foot deformity and joint limitation are often associated w/ _____________ and plantar ulceration.
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high foot pressure
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Pressure =
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force (body weight)/foot area
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Skin temperature measurement is useful in identifying areas of __________
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high foot stress and in predicting future ulceration or charcot fracture
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A ____ or greater skin temp diffference between feet may indicate the possibility of ulceration.
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4
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With claw toe formation, you will often see ulcers develop on _____________.
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the tips of toes,
these benign looking wounds often lead to ostomylitis |
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Hammer toe formation will often lead to corns on the ________________.
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dorsal surface of toes
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Limited joint mobility can often be due to ___________
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sensory loss
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If someone is hypermobile in dorsiflexion and limited in plantar, they are risk of developing_________
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heel ulcers
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A charcot foot is an osteoarthropathy that involves the bone and joints giving the foot a characteristic _________ shape
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rocker bottom
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