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The lecture Diabetic Foot Ulcers with Case by Michael Lazarus, MD is from the course Diabetes Mellitus. It contains the following chapters:
What is most likely to predispose the following patient to his foot ulcer? A 57-year-old man presents with progressive right foot swelling, redness, and malaise. He reports seeing a blister on his forefoot several months ago after using new work boots. He has dressed the affected area daily with bandages; however, the area has not healed. Medical history: Type 2 DM for 16 years, stage 2 chronic kidney disease for 3 years, and smoked 20–30 cigarettes daily for 25 years. Physical examination: Temperature of 38.1°C (100.6°F), blood pressure of 110/70 mm Hg, and pulse of 102 beats/min. There is a malodorous right foot ulcer overlying the first metatarsophalangeal joint. Fluctuance and erythema extend 3 cm beyond the ulcer border. Moderate pitting edema is notable over the remaining areas of the foot and ankle.
Which of the following would be least likely to have prevented the ulcer seen in the following patient? A 57-year-old man presents with progressive right foot swelling, redness, and malaise. He reports seeing a blister on his forefoot several months ago after using new work boots. He has dressed the affected area daily with bandages; however, the area has not healed. Medical history: Type 2 DM for 16 years, stage 2 chronic kidney disease for 3 years, and smoked 20–30 cigarettes daily for 25 years. Physical examination: Temperature of 38.1°C (100.6°F), blood pressure of 110/70 mm Hg, and pulse of 102 beats/min. There is a malodorous right foot ulcer overlying the first metatarsophalangeal joint. Fluctuance and erythema extend 3 cm beyond the ulcer border. Moderate pitting edema is notable over the remaining areas of the foot and ankle.
What is the best initial step for the patient in the following case? A 57-year-old man presents with progressive right foot swelling, redness, and malaise. He reports seeing a blister on his forefoot several months ago after using new work boots. He has dressed the affected area daily with bandages; however, the area has not healed. Medical history: Type 2 DM for 16 years, stage 2 chronic kidney disease for 3 years, and smoked 20–30 cigarettes daily for 25 years. Physical examination: Temperature of 38.1°C (100.6°F), blood pressure of 110/70 mm Hg, and pulse of 102 beats/min. There is a malodorous right foot ulcer overlying the first metatarsophalangeal joint. Fluctuance and erythema extend 3 cm beyond the ulcer border. Moderate pitting edema is notable over the remaining areas of the foot and ankle.
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