Y2B2B Cs- Ankle/foot Disease

Front 1

what is the number one general tx for disorders of the foot and ankle? what is the acronym associated? what is the purpose?

Back 1

IMMOBILIZATION
RICE
r- rest
i- ice
c-compression
e- elevation
casts, wooden shoes

goal: mostly to get rid of the edema

Front 2

what are the analgesics used to tx disorders of the foot and ankle?

Back 2

acetaminophen, NSAIDs, opiate analgesics

Front 3

what region of the foot is more frequently injured by women? why?

Back 3

forefoot due to shoes

Front 4

what region of the foot would you have chronic dorsal pain secondary to osteoarthritis?

Back 4

midfoot

Front 5

what is the most common problem concerning the hindfoot?

Back 5

plantar heel pain secondary to plantar fasciitis

Front 6

pain posterior and distal to medial malleolus in the region of the tendon
dx:

Back 6

posterior tibial rendon dysfunction

Front 7

what drug has a SE that can cause a spontaneous achilles tendon rupture in women of childbearing age?

Back 7

quinolones

Front 8

what test is used to test for achilles tendon rupture?

Back 8

thompson

Front 9

what does the pain of an achilles tendon rupture feel like?

Back 9

sudden onset "severe" calf painlike gunshot or hit w/ the racquet

Front 10

what is the tx for achilles tendon rupture?

Back 10

RICE for 5-6 days
nonsurgical--> casting/bracing, heel cord stretching about 7 days post injury
surgical--> casting 8 weeks followed by 8-12 weeks tapered heel lifts, pT +/- 6 months

Front 11

who is at a greatest risk for an ankle sprain?

Back 11

athletes and dancers

Front 12

what type of injury is an ankle sprain? where is it most commonly torn?

Back 12

inversion injury

MC: talofibular and calcaniofibular ligaments

Front 13

what would you see on physical exam of a sprained ankle?

Back 13

pain, swelling, loss of function at site
-ecchymosis entire ankle

Front 14

what is the ddx associated with ankle sprain?

Back 14

ankle fracture, peroneal tendon

Front 15

what are the goals of tx for an ankle sprain?

Back 15

pain relief, prevent instability

Front 16

what are the txs for ankle sprain?

Back 16

NSAIDs, RICE (air brace, ace wrap), achilles stretching, balancing exercising

Front 17

what sensory neuropathy signs will you see on a diabetic foot? what about motor neuropathy?

Back 17

sensory: skin ulcerations, infection
motor: intrinsic motor weakness /w claw toe, subluxations

Front 18

what affect does vascular insufficiency have on the diabetic foot?

Back 18

results in poor wound healing and advances neuropathy--> resulting in chronic bone degeneration

Front 19

what is a charcot joint?

Back 19

repetitive stress/trauma d/t loss of proprioception resulting in deformity and subluxations. Swelling, warmth, redness w/ diminished or absent pain

Front 20

how would distinguish charcot joint on a diabetic foot testing?

Back 20

charcot: hot, red, swollen w/ intact skin

Front 21

what do you need to check when you find an ulcer on a diabetic foot?

Back 21

if there is boney involvement

Front 22

what are the ddx associated with diabetic foot?

Back 22

cellulitis, gout, osteomyelitis, other neuropathies

Front 23

what you do for every diabetic pt?

Back 23

thorough evaluation of foot: motor sensory, range of motion, insepection/palpation of skin

Front 24

how do you tell the difference between charcot-marie-tooth and diabetic cause of neuropathy?

Back 24

glucose test

Front 25

what is goal of the tx for diabetic foot?

Back 25

prevent amputations

Front 26

what does it mean when you see callouses on the foot of a diabetic?

Back 26

that there is a lot of pressure at that point and it could lead to charcot and then ambutation

Front 27

most infections in diabetics are _____microbial

Back 27

poly

Front 28

how do we teach diabetic foot self care?

Back 28

teach self inspection daily
no bare feet, socks at night, no heating pads
watch for maceration
thick nails

Front 29

what is a lisfranc fracture? what region of the foot is associated?

Back 29

traumatic disruption of the second tarsometatarsal joint. Invert and evert the foot. the pain from the pt will show a fracture.

midfoot fracture

Front 30

if xray is normal and you suspect a lisfranc fracture, what do you do next?

Back 30

CT or MRI

Front 31

which fracture is more stable, unilateral or bilateral?

Back 31

unilateral

Front 32

what is a tri-Malleolar fracture?

Back 32

bilateral malleoli and fracture posterior malleolus (distal posterior tibia) w/ or w/o dislocation. completely unstable

Front 33

How do you judge circulation in a completely edematous ankle?

Back 33

capillary refill and doppler

Front 34

why would you be concerned about neurovascular compromise in a very edematous ankle?

Back 34

compartment syndrome

Front 35

what is the tx for ankle fracture? (stable and unstable)

Back 35

stable: casting, nonweight bearing 6 weeks
unstable: open reduction

Front 36

what region of the foot is associated with calcaneal and talus fracture? what should be your greatest concern with this type of fracture?

Back 36

hindfoot

-you must think cephalad- tibia? fibula? femur? hip? spine?

Front 37

how do you usually get a calcaneal and talus fracture?

Back 37

high velocity: motor vehicle, falls

Front 38

what region of the foot is associated with fracture of metatarsals? what is this place common for?

Back 38

forefoot fractures
common place for stress fracture and insufficiency fractures

Front 39

what are metatarsal stress fractures associated with?

Back 39

osteoporosis

Front 40

what is the most commonly fractured toe?

Back 40

baby toe

Front 41

what is a frieberg infarction?

Back 41

avascular necrosis

Front 42

what is a stress fracture do to? what is it d/t?

Back 42

insufficiency; d/t repetitive loading: fatigue> repair

Front 43

what are the risk factors for stress fractures?

Back 43

young female athletes (who have amenorrhea, osteopenia and eating disorder), osteoporosis

Front 44

what is the most common foot bone to have a stress fracture?

Back 44

2nd metatarsal

Front 45

what is a interdigital (morton) neuroma?

Back 45

perineural fibrosis of the digital nerve btwn metatarsal heads: not a true neuroma--> inflames the area around the nerve

Front 46

what gender is most commonly affected by morton's neuromas? why?

Back 46

females; tight compressing shoes

Front 47

with what 2 disorders of the foot and ankle do you get burning dysethesias?

Back 47

morton neuroma and tarsal tunnel syndrome

Front 48

what is the most common cause of heel pain in adults? what is it most likely due to?

Back 48

plantar fasciitis--> d/t degenerative tear of part of the fascial origin from calcaneus

Front 49

what population is most commonly affected?

Back 49

overweight women

Front 50

what is the tx for plantar fasciitis?

Back 50

heel pads, ice, NSAID's, injection

Front 51

what is tarsal tunnel syndrome? what sign can confirm this?

Back 51

compression neuropathy of tibial nerve or branches posterior to medial malleolus. Tinnel's sign

Front 52

what is turf toe? what is it usually d/t? what is the tx?

Back 52

sprain of the 1st MTP most frequently d/t hyperextension
tx: RICE, splint, occasional open reduction