Term
|
Definition
1) Smoking
2) Obesity
3) Diabetes
4) Hypertension |
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Term
|
Definition
Hypertension
Dyslipidemia
Type 2 diabetes
Coronary heart disease
Stroke
Gallbladder disease
Osteoarthritis
Sleep apnea
Respiratory problems
Endometrial cancer
Breast cancer
Colon cancer |
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Term
| Why do diabetic foot ulcers occur? |
|
Definition
impaired sensation (distal
symmetric polyneuropathy) and impaired perfusion (diabetes vasculopathy
and peripheral vascular disease).
evaluate pedal pulses (strongest indicator of periph vasc disease |
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Term
|
Definition
Grade 1: superficial, outpatient
Grade 2: deep ulcer no bone, outpatient
Grade 3: deep ulcer +cellulits +abscess, may need hosp
4) Local gangrene, emergent hosp
5) Extensive gangrene, emergent hosp |
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Term
| Ddx of unilateral leg swelling |
|
Definition
Cellulitis (infectious process, usually + fever)
DVT (swelling, pain, discoloration, inc risk w/ smoking, ocp, obesity)
Venous Insufficiency (can follow DVT, dull ache on standing that resolves w elevation)
Lymphedema (generally painless, chronic dull, heavy sensation in leg)
PVD (claudication w exercise, smoking is major risk, diabetes is major risk factor) |
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Term
| Studies to order in unilateral leg swelling |
|
Definition
Doppler US
D-dimer (can rule out DVT)
CBC
BUN, glucose, Cr
Coag studies
HbA1C
Wells criteria, high prob 3 or more (cancer, paralysis, bedridden, tenderness along venous sys, leg swollem calf swelling, pitting edema, colateral superficial veins, alt. dx present) |
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Term
|
Definition
Goals: inhib growth, thromboembolic resolution, prev of recurrence
Heparin (IV, req hospitalization)
LMWH ( long half life, no lab monitoring, Outpatient)
Warfarin (6-12 wks if isolated event, 3 months if first time, 12m-indef if recurrent)
Criteria for Outpatient (hemodyn stable, good kidney fcn, low risk of bleeding, stable home env, daily INR monitoring access) |
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Term
| INR monitoring in Warfarin |
|
Definition
check 3 days after
INR >5 and <9 discontinue and repeat in 24 hours
INR> 9, hold warfarin and give oral vit K |
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Term
| When to screen for intherited thrombophilia? |
|
Definition
Initial thrombosis before 50 wo risk factor
fam hx
recurrent venous thrombosis
thombosis in unusual vascular beds (portal, hepatic etc) |
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