Podiatry Post Assessment UPDATED
Actual Exam Questions and CORRECT
Answers
almost all OM originate from an infected foot ulcer while OA(charcot neuropathy) is a non-
infectious process from..... - CORRECT ANSWER- ✔✔peripheral neuropathy
What foot problem is the most common in diabetes? - CORRECT ANSWER- ✔✔foot
ulceration
20-60 percent of foot infections are accompanied by what? - CORRECT ANSWER-
✔✔underlying bone infection (OM)
General treatment of DFO (Diabetic foot osteomyelitis)? - CORRECT ANSWER-
✔✔antibiotic therapy and
surgical debridement
How is CN treated in acute stage? - CORRECT ANSWER- ✔✔immobilization and pressure
off-loading, often combined with various bone-enhancing medications.
DFO is almost always cause by... - CORRECT ANSWER- ✔✔bacteria, either with a single
organism or as part of a polymicrobial infection
Cut-off values of >___cm for the ulcer size and >___ mm for the ulcer depth are useful in
diagnosing DFO. - CORRECT ANSWER- ✔✔2
3
OM typically involves the toes and forefoot while CN causes bony destruction of..... -
CORRECT ANSWER- ✔✔midfoot
How many degrees higher in the affected foot than the unaffected foot in CN? - CORRECT
ANSWER- ✔✔>2 degrees celcius
,What is there usually a history of in CN? - CORRECT ANSWER- ✔✔foot trauma
likelihood of infection is reduced in CN because of two reasons.... - CORRECT ANSWER-
✔✔absence of current or recent foot ulceration
when affected leg is kept elevated there is a decrease in erythema
between DFO and CN, which is mostly related elevated systemic inflammatory markers? -
CORRECT ANSWER- ✔✔DFO
ESR > what supports DFO diagnosis? - CORRECT ANSWER- ✔✔70
(not seen in cellulitis)
What labs are usually normal in CN but high in DFO? - CORRECT ANSWER- ✔✔blood
leukocyte counts
C-reactive protein
procalcitonin concentrations
(but non-specific)
Gold standard for diagnosing DFO - CORRECT ANSWER- ✔✔bone biopsy
needs to be positive for both culture and histopathology
many favor what as gold standard over bone culture?
Why? - CORRECT ANSWER- ✔✔histophathology
,bone culture can be contaminated by wound-colonizing flora, or false-negative results from
sampling errors
What are characteristic histological findings? - CORRECT ANSWER- ✔✔aggregates of
inflammatory cells, erosion of trabecular bone and marrow changes, including loss of normal
fat, fibrosis and reactive bone formation
Clinical situations in which diagnostic bone biopsy is particularly useful.... - CORRECT
ANSWER- ✔✔-needs definitive diagnosis to justify the choice of early surgery
-cultures of soft tissue or blood suggest high risk of OM
-progressive bony deterioration
-suspected bone is planned target for insertion of orthopaedic metaware
What is the the first diagnostic test when evaluating bone involvement in diabetic foot? -
CORRECT ANSWER- ✔✔plain film radiaograph
What are the most common findings of OM on plain radiographs?
When do these findings typically become visible? - CORRECT ANSWER-
✔✔demineralisation
periosteal reaction
cortical destruction
2nd or 3rd week following infection (requires 40-50 percent bone loss to see them)
What are some false positives of 3 phase bone scintigraphy?
Negative results exclude what? - CORRECT ANSWER- ✔✔trauma, arthritis, remodelling
bone, recent surgery, CN
infection
, What is the sensitivity and specificity of 3 phase bone scan? - CORRECT ANSWER-
✔✔high
low
What is the sensitivity and specificity of leukocyte scintigraphy? - CORRECT ANSWER-
✔✔high
high
What is the best imaging test for detecting bone and soft-tissue involvement? - CORRECT
ANSWER- ✔✔MRI
What joints are fused in medial column fusion? - CORRECT ANSWER- ✔✔MCJ
NCJ
TNJ
Excessive medial column motion is often blamed on.....
It is the authors belief in mcglammeries that significant medical columne motion occurs at
the... - CORRECT ANSWER- ✔✔MCJ
NCJ
The TNJ provides tremendous movement within what part of the foot?
Arthrodesis of this joint will result in ..... - CORRECT ANSWER- ✔✔hindfoot
tremendous limitation of adjacent joint movement, essentially locking up the subtalar and
calcaneocuboid joints
When posterior tibial tendon is salvageable in a flexible flatfoot, it is preferred to support this
medial joint with realignment of the midfoot and hindfoot prior to arthrodesis. Medial fusion
of what will help in this direction? - CORRECT ANSWER- ✔✔NCJ
Actual Exam Questions and CORRECT
Answers
almost all OM originate from an infected foot ulcer while OA(charcot neuropathy) is a non-
infectious process from..... - CORRECT ANSWER- ✔✔peripheral neuropathy
What foot problem is the most common in diabetes? - CORRECT ANSWER- ✔✔foot
ulceration
20-60 percent of foot infections are accompanied by what? - CORRECT ANSWER-
✔✔underlying bone infection (OM)
General treatment of DFO (Diabetic foot osteomyelitis)? - CORRECT ANSWER-
✔✔antibiotic therapy and
surgical debridement
How is CN treated in acute stage? - CORRECT ANSWER- ✔✔immobilization and pressure
off-loading, often combined with various bone-enhancing medications.
DFO is almost always cause by... - CORRECT ANSWER- ✔✔bacteria, either with a single
organism or as part of a polymicrobial infection
Cut-off values of >___cm for the ulcer size and >___ mm for the ulcer depth are useful in
diagnosing DFO. - CORRECT ANSWER- ✔✔2
3
OM typically involves the toes and forefoot while CN causes bony destruction of..... -
CORRECT ANSWER- ✔✔midfoot
How many degrees higher in the affected foot than the unaffected foot in CN? - CORRECT
ANSWER- ✔✔>2 degrees celcius
,What is there usually a history of in CN? - CORRECT ANSWER- ✔✔foot trauma
likelihood of infection is reduced in CN because of two reasons.... - CORRECT ANSWER-
✔✔absence of current or recent foot ulceration
when affected leg is kept elevated there is a decrease in erythema
between DFO and CN, which is mostly related elevated systemic inflammatory markers? -
CORRECT ANSWER- ✔✔DFO
ESR > what supports DFO diagnosis? - CORRECT ANSWER- ✔✔70
(not seen in cellulitis)
What labs are usually normal in CN but high in DFO? - CORRECT ANSWER- ✔✔blood
leukocyte counts
C-reactive protein
procalcitonin concentrations
(but non-specific)
Gold standard for diagnosing DFO - CORRECT ANSWER- ✔✔bone biopsy
needs to be positive for both culture and histopathology
many favor what as gold standard over bone culture?
Why? - CORRECT ANSWER- ✔✔histophathology
,bone culture can be contaminated by wound-colonizing flora, or false-negative results from
sampling errors
What are characteristic histological findings? - CORRECT ANSWER- ✔✔aggregates of
inflammatory cells, erosion of trabecular bone and marrow changes, including loss of normal
fat, fibrosis and reactive bone formation
Clinical situations in which diagnostic bone biopsy is particularly useful.... - CORRECT
ANSWER- ✔✔-needs definitive diagnosis to justify the choice of early surgery
-cultures of soft tissue or blood suggest high risk of OM
-progressive bony deterioration
-suspected bone is planned target for insertion of orthopaedic metaware
What is the the first diagnostic test when evaluating bone involvement in diabetic foot? -
CORRECT ANSWER- ✔✔plain film radiaograph
What are the most common findings of OM on plain radiographs?
When do these findings typically become visible? - CORRECT ANSWER-
✔✔demineralisation
periosteal reaction
cortical destruction
2nd or 3rd week following infection (requires 40-50 percent bone loss to see them)
What are some false positives of 3 phase bone scintigraphy?
Negative results exclude what? - CORRECT ANSWER- ✔✔trauma, arthritis, remodelling
bone, recent surgery, CN
infection
, What is the sensitivity and specificity of 3 phase bone scan? - CORRECT ANSWER-
✔✔high
low
What is the sensitivity and specificity of leukocyte scintigraphy? - CORRECT ANSWER-
✔✔high
high
What is the best imaging test for detecting bone and soft-tissue involvement? - CORRECT
ANSWER- ✔✔MRI
What joints are fused in medial column fusion? - CORRECT ANSWER- ✔✔MCJ
NCJ
TNJ
Excessive medial column motion is often blamed on.....
It is the authors belief in mcglammeries that significant medical columne motion occurs at
the... - CORRECT ANSWER- ✔✔MCJ
NCJ
The TNJ provides tremendous movement within what part of the foot?
Arthrodesis of this joint will result in ..... - CORRECT ANSWER- ✔✔hindfoot
tremendous limitation of adjacent joint movement, essentially locking up the subtalar and
calcaneocuboid joints
When posterior tibial tendon is salvageable in a flexible flatfoot, it is preferred to support this
medial joint with realignment of the midfoot and hindfoot prior to arthrodesis. Medial fusion
of what will help in this direction? - CORRECT ANSWER- ✔✔NCJ
