Our August 24th Question of the week quizzed test takers on thick calluses coupled with leg pain. 61% of respondents chose the correct answer. We thought that this was an important topic to discuss further, so we can pass on correct info to people living with diabetes.
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question
Question: JR has lived with type 1 diabetes for over twenty years. JR arrived in the clinic with thick calluses on both feet and complaints of calf pain when walking for more than 10 minutes. JR’s pulses are difficult to palpate.
What diagnosis best matches JR’s presentation?
Answer Choices:
As shown above, the most common choice was option 3, the second most common answer was option 1, then option 2, and finally option 4.
If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer. If you want to learn more about lower extremities, we invite you to join our Virtual Course or check out our Level 2 Online Courses.
Answer 1 is incorrect. 15.33% chose this answer, “Peripheral polyneuropathy.” This juicy answer is tempting, however it does not match the symptoms detailed by JR. A person with peripheral polyneuropathy will typically complain of numbness, tingling and leg pain at night. They may also have thick calluses. However, there are two clues that indicate a mismatch between question and answer. JR is “complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses.” These chief complaints indicate a different pathology. Keep reading to find out more.
Answer 2 is incorrect. 14.50% of you chose this answer, “Diabetes venous stasis syndrome.” This is another juicy answer with a made up condition that is designed to sound familiar. In general, with venous disease, pulses are still palpable since there is adequate blood flow to lower extremities. There are two clues that indicate a mismatch between question and answer. “JR is complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses.” These chief complaints indicate a different pathology. Keep reading to find out more.
Answer 3 is correct. 60.64% of respondents chose this answer, “Peripheral arterial disease.” YES, this is the BEST answer. Great job. JR is exhibiting the classic signs of inadequate arterial blood flow to the lower extremities, or peripheral arterial disease. JR’s complaints of “calf pain when walking for more than 10 minutes with difficulty locating pulses” indicate poor arterial circulation and warrant referral to a provider for complete CV risk assessment.
Finally, Answer 4 is incorrect. 9.53% chose this answer, “Charcot foot.” This answer is tempting. Charcot foot is characterized by severe foot inflammation and structural collapse. Since JR is “complaining of calf pain when walking for more than 10 minutes with difficulty locating pulses”, these symptoms do not match the usual complaints associated with Charcot foot. Good try, see answer 3 for more info.
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
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