PC Treatment Planning & Management 2

Question 1

A diabetic patient with a Wagner Grade 2 foot ulcer has adequate perfusion. What is the most appropriate initial treatment approach?

Accepted Answer

Debridement, offloading, and antibiotics for clinical infection

Answer

Immediate amputation

Answer

Hyperbaric oxygen therapy only

Answer

Topical antifungal application

Question 2

Which orthotic design is most appropriate for a patient with a flexible flatfoot and symptomatic posterior tibial tendon dysfunction (PTTD) Stage I?

Accepted Answer

Rigid functional orthosis with medial heel skive and deep heel cup

Answer

Accommodative orthosis with metatarsal pad

Answer

Toe spacer and padding only

Answer

Carbon fiber full-length orthosis with lateral flange

Question 3

A patient presents with recurrent ingrown toenails despite conservative care. The most definitive surgical option is:

Accepted Answer

Winograd procedure (partial nail avulsion with matricectomy)

Answer

Nail debridement and packing

Answer

Zadik procedure (total nail avulsion with complete matricectomy)

Answer

Splinting with gutter splint only

Question 4

When treating Achilles tendinopathy with eccentric exercise, what protocol is most evidence-based?

Accepted Answer

Alfredson protocol: 3 sets of 15 repetitions twice daily, 12 weeks

Answer

Concentric heel raises once daily for 2 weeks

Answer

Static stretching only three times per week

Answer

Isokinetic training at high velocity daily

Question 5

A patient with rheumatoid arthritis develops hallux valgus with lesser toe deformities causing painful metatarsal head pressure. The preferred surgical reconstruction is:

Accepted Answer

Pan-metatarsal head resection with first MPJ arthrodesis

Answer

Isolated first MPJ fusion only

Answer

Keller bunionectomy with simple hammer toe correction

Answer

Chevron osteotomy alone

Question 6

Which dressing type is most appropriate for a heavily exudating, non-infected chronic venous ulcer?

Accepted Answer

Alginate or foam dressing with compression therapy

Answer

Dry gauze changed every 24 hours

Answer

Hydrocolloid occlusive dressing

Answer

Petroleum-impregnated gauze only

Question 7

A 14-year-old presents with heel pain worsening with activity. X-ray shows fragmentation of the calcaneal apophysis. The most appropriate treatment is:

Accepted Answer

Activity modification, heel lifts, stretching, and NSAIDs as needed

Answer

Surgical excision of the apophysis

Answer

Immobilization in a cast for 6–8 weeks only

Answer

Corticosteroid injection into the growth plate