PC Clinical Procedures & Protocols 3 — Questions and Answers
Question 1: A patient with diabetes undergoes a wound culture revealing Pseudomonas aeruginosa. Which wound characteristic is most commonly associated with this organism?
- Black eschar with dry borders
- Sweet fruity odor with blue-green exudate (Correct answer)
- Malodorous yellow slough
- Dry necrotic tissue with erythema
Correct answer: Sweet fruity odor with blue-green exudate
Pseudomonas aeruginosa produces pyocyanin (blue-green pigment) and a distinctive fruity odor due to its metabolic byproducts.
Question 2: The ankle-brachial index (ABI) value indicating moderate peripheral arterial disease that warrants vascular surgery referral is:
- 0.91–1.0
- 0.7–0.9
- 0.41–0.69 (Correct answer)
- Below 0.4
Correct answer: 0.41–0.69
An ABI of 0.41–0.69 indicates moderate PAD, which typically requires vascular surgery consultation before elective podiatric procedures.
Question 3: During a hammertoe arthroplasty, the resection is performed at which joint?
- Metatarsophalangeal joint
- Proximal interphalangeal joint (Correct answer)
- Distal interphalangeal joint
- Tarsometatarsal joint
Correct answer: Proximal interphalangeal joint
Hammertoe arthroplasty involves resection of the head of the proximal phalanx at the proximal interphalangeal joint to relieve the deformity.
Question 4: Which suture material is preferred for closing a plantar skin incision due to its high tensile strength and knot security?
- Plain gut
- Chromic gut
- Nylon (Prolene) (Correct answer)
- Polyglactin 910 (Vicryl)
Correct answer: Nylon (Prolene)
Nylon (monofilament non-absorbable) provides superior tensile strength and is preferred for plantar closures that endure high mechanical stress.
Question 5: In the management of an acute Charcot foot, the hallmark initial treatment is:
- Immediate surgical reconstruction
- Total contact casting with strict non-weight-bearing (Correct answer)
- Custom orthotic fitting
- Bisphosphonate therapy alone
Correct answer: Total contact casting with strict non-weight-bearing
Total contact casting with protected weight-bearing or non-weight-bearing is the cornerstone of acute Charcot neuroarthropathy management to offload and immobilize the foot.
Question 6: Which radiographic view is most useful for evaluating sesamoid pathology in the hallux?
- Dorsoplantar view
- Lateral oblique view
- Axial (tangential) sesamoid view (Correct answer)
- Calcaneal axial view
Correct answer: Axial (tangential) sesamoid view
The axial sesamoid view (tangential projection) projects the sesamoids free of superimposition, allowing clear evaluation of sesamoid pathology.
Question 7: Which local anesthetic agent is preferred for procedures requiring a prolonged duration of action exceeding 8 hours?
- Lidocaine 2%
- Mepivacaine 1.5%
- Bupivacaine 0.5% (Correct answer)
- Prilocaine 4%
Correct answer: Bupivacaine 0.5%
Bupivacaine 0.5% provides the longest duration of action among common podiatric local anesthetics, offering analgesia for up to 8–12 hours.
PC Clinical Procedures & Protocols 3
A patient with diabetes undergoes a wound culture revealing Pseudomonas aeruginosa.
Which wound characteristic is most commonly associated with this organism?