DPM Vascular & Neurological Conditions of the Lower Extremity Flashcards

What is the most common underlying cause of peripheral neuropathy in the United States?

Answer: Diabetes mellitus

Diabetic peripheral neuropathy is the most common cause of peripheral neuropathy in the US, affecting up to 50% of diabetic patients.

Which type of nerve fiber is first affected in diabetic peripheral neuropathy?

Answer: Small unmyelinated C fibers and Aδ fibers

Small fiber neuropathy affects unmyelinated C fibers (pain, temperature) and thinly myelinated Aδ fibers first, causing burning pain before large-fiber deficits appear.

Which clinical finding is characteristic of Raynaud's phenomenon in the feet?

Answer: Triphasic color change: white → blue → red with cold exposure

Raynaud's phenomenon causes episodic vasospasm resulting in a classic triphasic color change (pallor → cyanosis → erythema) triggered by cold or emotional stress.

An ABI value greater than 1.3 in a diabetic patient suggests:

Answer: Non-compressible calcified vessels giving falsely elevated readings

In diabetic and elderly patients, medial arterial calcification can render vessels incompressible, producing falsely elevated ABI values above 1.3 that do not reflect true arterial perfusion.

Which medication class is the cornerstone of medical management for symptomatic peripheral arterial disease?

Answer: Antiplatelet agents (aspirin or clopidogrel)

Antiplatelet therapy with aspirin or clopidogrel reduces cardiovascular events and is the cornerstone of medical management for PAD.

Which monofilament test is the standard for screening loss of protective sensation in the diabetic foot?

Answer: 10-gram Semmes-Weinstein monofilament

The 10-gram Semmes-Weinstein monofilament is the standard clinical tool for detecting loss of protective sensation in diabetic patients at risk for foot ulceration.