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Podiatry - Clinical Exam Questions With 100% Solved Answers, Already Passed!!
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Podiatry - Clinical Exam Questions With 100% Solved Answers, Already Passed!!
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Podiatry - Clinical Exam Questions With 100% Solved Answers, Already Passed!!Define PAD - Peripheral arterial disease Answer - Comprises those entities which result in obstruction to blood flow in the arteries
What are the risk factors associated with the development of PAD? Answer - 1) Smoking
2) Hypertension
3) Hyperlipidaemia
4) DM
5) CVD - cardio vascular disease
6) Male
7) Low physical activity
In podiatry when should we undertake a vascular screening? Answer - All adults over the age of 65 & all adults over the age of 50 with a history of DM or other risk factors
What can impaired arterial supply to the lower limbs result in? Answer - 1) Hypohidrotic skin
2) Reduced hair growth
3) General thickening of nails
4) Limb temperature
5) Pulselessness
6) Change in skin colour
Dermatological changes in patients with PAD - explain what happens Answer - 1) Impaired arterial supply to tissue of the lower extremity is associated with several observable pathological changes to the skin and adnexa
2) Patients tend to develop anhidrotic skin due to the metabolic demands of the dermal structures not being met
In a patient that has impaired arterial supply what changes would you expect to the hair growth on the lower limbs? Answer - Hair growth requires adequate supply of nutrients to the hair follicle to ensure growth. Note: if there is a lack of hair always check with the patient this is normal (i.e. do they
wax/shave)
How is PAD and the general thickening of nails associated? Answer - General thickening of nails occurs with damage to the nail matrix, ageing and due to PAD.
In the presence of significant arterial disease this is enhanced
Note: If there is uniformed thickening on all digits and there is no fungal infection suspect impaired arterial supply
When assessing a patients limb temperature - what would you expect a sharp drop in temp at the foot mean? Answer - Normally there is more warmth proximally with a gradual cooling as you move distally - a sharp drop indicated poor blood supply
Define IC - intermittent claudication Answer - Is transient ischaemic muscle pain that occurs during exercise.
IC is a strong clinical indicator of the presence of significant PAD
Why does intermittent claudication cause pain in movement/exercise? Answer - Pain
is felt when the accumulation of metabolic by-products within the muscle is at high enough concentrations to activate pain receptors
More exercise results in more pain
What are the clinical signs and symptoms of IC? Answer - 1) IC is characterised by the presence of aching, cramp-like pain and tiredness
2) Pain is usually located in a specific compartment - frequently the calf muscles
Define critical limb Ischaemia Answer - 1) CLI represents the end stage of PAD
2) Is where peripheral flow is reduced to the point at which the patient has chronic ischaemic rest pain, or ischaemic skin lesions
How can we clinically diagnose CLI? Answer - By completing a toe/ankle systolic pressure
Define Rest pain Answer - Rest pain is persistent pain caused by nerve ischaemia leading to ischaemic neuropathy
When does Rest pain typically present? Answer - Pain presents typically when legs are elevated
How do patients usually describe Rest pain? Answer - The pain associated with ischaemic neuropathy is generally described as sharp, shooting, but poorly localised
The pain radiates throughout the extremity but follows no distinct nerve root & commonly presents as a tearing, pulling, burning, throbbing and tingling feeling
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