USMLE Step 3 - Diabetic Ulcers
Diabetic Ulcers
yehia1982 - 10-24-08 15:21
A 73-year-old diabetic female presents with a 1 cm ulceration on the medial edge of the foot near the first metastarsal head. There is surrounding erythema of the skin and some exudative drainage is noted. Which one of the following statements is true regarding this problem ?
a. a swab of the ulcer for culture is likely to identify the invading pathogen
b. gram-negative rods are seldom isolated
c. debridement and appropriate dressings should be considered to promote healing
d. providone-iodine (betadine) ointment should be applied continuously to the wound
yehia1982 - 10-24-08 15:21
A 73-year-old diabetic female presents with a 1 cm ulceration on the medial edge of the foot near the first metastarsal head. There is surrounding erythema of the skin and some exudative drainage is noted. Which one of the following statements is true regarding this problem ?
a. a swab of the ulcer for culture is likely to identify the invading pathogen
b. gram-negative rods are seldom isolated
c. debridement and appropriate dressings should be considered to promote healing
d. providone-iodine (betadine) ointment should be applied continuously to the wound
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#2
Re: Diabetic Ulcers sackatdoc - 10-31-08 11:45 swab of ulcer to identify the organism with right anti bx is the treatment of choice owing to factors implicating the delayed healing of the ulcer,and of the choices are for general ulcer management.
#3
Re: Diabetic Ulcers shumayla - 11-02-08 09:34 c. debridement and appropriate dressings should be considered to promote healing
#4
Re: Diabetic Ulcers sackatdoc - 11-02-08 10:22 but thats for every ulcer management, right?so what is the protocol for diabetic ulcer, treatment needs to be aggressive along with the debridement and appropiate dresings.actually both the choices are correct, i guess
#6
Re: Diabetic Ulcers doctor1 - 11-03-08 12:19 c, because the primary cause of the fot ulcer in diabetes is not infection its lack of required vascular supply , and subsequesnt neuropathy which causes decrease in the sensation and perdisposes to repeated trauma leading to ulcer for,mation,, ............this is further increased with superimposed infection , and it usually is poly microbial so appropriate management is debridement and appropriate dressings should be considered to promote healing, incase signs of infection are presntn then emperic treatmetn is to be given oral , incase of severe infection then go ahead with iv treatment............ so the antibiotic of choice is not dependent on the cuklture results, and use of antibiotics is decided by presence/ absence of infection but hte definitive treatment is use of proper non contact cast, increase blood circulation and woumd debridement
#7
Re: Diabetic Ulcers sackatdoc - 11-03-08 12:40 what is the reference doctor1, coz such a elaborate explanantion though looks convincing but has to be confirmed with the name of the reference, it would be great, if you could provide one, thanks.
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