diabetes q - ketty

[ArchivalUser]

I would choose B, x-ray to check the gas in the soft tissue, not look for osteomyeolitis. If there is gas in the leg, local drain will not work, either amputation or debrigement is required. Antibiotics can be an adjuvant method, not the mainstay trt.

[ArchivalUser]

what I meant above was xray initial, if it is abnormal, then further investigation is mandatory, such as MRI or bone scan to look for how deep the ucler involves...I agree with tubreeze's Tx plan

[ArchivalUser]

If I remember correctly, this Q exactly shows somewhere on UW. But a stupid thing is I don't remember the answer.
I'll post it later. As far as I remember, it's necrotizing fasciitis.

[ArchivalUser]

Answer:Incision and drainage the Ulcer

A. sending home is a NO NO
B. X-ray might show gas , too early for osteomyelitis changes
D. serum K ---no use

Question is --Most appropriate next step in management to limit disability:

several important information:
1.decreased pulses
2. Crepitus
3.wound more than 2cm
4. patient septic

this is what I found from AAFP.
Presence of deep infection, abscess, cellulitis, gangren, osteomyelitis prompt surgical drainage is indicated in order to salvage limb.


IV Antibiotics is a must- this is next immediate step, but the question is 'most appropriate next step in Mmg to limit diabiliy'

My answer would be - incision and drain to remove foul tissue and abx Clinda + Cipro or other combinations to cover( anaerobs, gr -, gr+)




first do everything possible to salvage the limb!! its easy to amputate, question itself says management to "limit disability"

[ArchivalUser]

Answer:Incision and drainage the Ulcer

A. sending home is a NO NO
B. X-ray might show gas , too early for osteomyelitis changes
D. serum K ---no use

Question is --Most appropriate next step in management to limit disability:

several important information:
1.decreased pulses
2. Crepitus
3.wound more than 2cm
4. patient septic

this is what I found from AAFP.
Presence of deep infection, abscess, cellulitis, gangren, osteomyelitis prompt surgical drainage is indicated in order to salvage limb.


IV Antibiotics is a must- this is next immediate step, but the question is 'most appropriate next step in Mmg to limit diabiliy'

My answer would be - incision and drain to remove foul tissue and abx Clinda + Cipro or other combinations to cover( anaerobs, gr -, gr+)




first do everything possible to salvage the limb!! its easy to amputate, question itself says management to "limit disability"

[ArchivalUser]

this ans should be X-ray.

it is not too early for osteomyelitis changes, patient had chronic ulcer from DM, not trauma. so x ray will work.