eQuizShow
PCP 1
Legislation and interview
Question: Under scope of practiceguidelines provided from the Podiatry Board of New Zealand a Podiatrist is....
Answer: A registered primary health care practitioner (including those previously registered as a chiropodist) who utilises medical, physical, palliative and surgical means other than those prescribed in the Podiatric Surgeon Scope of Practice, to provide diagnostic, preventative and rehabilitative treatment of conditions affecting the feet and lower limbs
Question: What is the purpose of the Health Practitioners Competence Assurance Act (HPCAA)
Answer: To protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practice their professions
Question: What is the main purpose of the Health and Disability Commissioners Act?
Answer: Promotes education on patients rights
Provides for advocates to negotiate problems
Provides for investigators of complaints against providers
Question: There are 5 aims of the patient interview, list the 5 specific aims
Answer: To identify the presenting problem or chief
complaint (CC)
To form a wider “clinical picture” which may
influence CC or treatment plan
To identify possible aetiology of the CC
To determine appropriate clinical assessments
Gain the patient’s trust and confidence in the
practitioner
Question: List the exact questions asked for PQRST
Answer: Position / Provocation
– Where does the pain
or symptoms occur?
– Ask the patient to
point to the area
– What triggers patient’s symptoms?
Quality / Quantity
– What does the
symptom feel like?
– Are you experiencing the
symptoms right now?
– Does the symptom
affect your normal
activities and if so to what degree?
Relieves/Exacerbates
– What do you do to make it better?
– What makes it feel worse?
How severe is the symptom?
- How would you rate it from 1-10?
– Is it getting worse, better or staying the same?
Timing/Treatment
– When did the symptoms begin?
Sudden or gradual onset?
– Occurrence and duration?
– What treatment have you sought to date?
Skin and Nails
Question: List the layers of the skin starting at the most superficial layer
Answer: Stratum CorneumStratum Granulosum
Stratum Spinulosum
Stratum Basale
Question: 7 Facts about the nail bed
Answer: Extends from lunula to hyponychium
Does not contribute to formation of nail plate
Nail plate attached via corrugations on ventral surface of plate which correspond with nail bed
As new nail is produced plate glides over the nail bed
Rich source of nutrients/blood vessels giving pink colour
Epidermis of nail bed does not possess granular layer - but can form in certain pathological states
So nail bed does not become keratinized other than in certain disease states
Question: What is the HYPONYCHIUM? Describe what it is, it's function and relevance to us
Answer: Epidermal tissue distal to nail bed Tissue connecting distal ventral plate to apex of nail bed. (distal nail fold) Functions as a distal seal to under surface of nail Punctured by too short. Affected by biomechanical conditions Plantar Pressure causes nail plate to
Question: What are the distinguishing features of verruca?
Answer: Relatively rapid onset
May or may not be present under bony prominences
Skin lines pass around lesion
Maximum pain on squeezing side to side
End arteries visible on paring
Rapid recurrence after shaving and padding
Question: List the Indications, compositions and contraindications for salicylic acid and silver nitrate
Answer: Indications
Salicylic Acid
-Treatment of VP, HD
Causes maceration of stratum
corneum allowing permeation into
the lower layers of epidermis
where it has a necrotic effect on
cells undergoing keratinisation
Silver Nitrate
Treatment of VP
Superficial effect through
reaction with constituents
of sweat. Causes shrinkage
of denuded skin forming a
black eschar which is then
debrided.
Composition
Salicylic Acid
A light feathery crystalline powder
mixed into a soft paraffin base
(usually at 60% for treatment of VP)
Silver Nitrate
In the form of a
toughened stick produced
by fusing 75% silver
nitrate with 25%
potassium nitrate
Contra Indications
Salicylic Acid
Can cause ulceration. Care must be
taken to mask healthy skin
surrounding the lesion to be
treated. Should not be left on for
more than 48 hours.
Silver Nitrate
Should not be used on
sensitive skin or
interdigitally. Black eschar
may be unsightly to
patient.
Abbreviations
Question: What does HD, HMIL and HMolle stand for and describe its general name
Answer: HD - Heloma Durum - Hard CornHMIL- Heloma Millaire - Seed corn
HMolle - Heloma Molle - Soft Corn
Question: What does O/C, O/G and O/X stand for
Answer: O/C = Onychocryptosis
O/G = Onychogryphosis
O/X = Onychauxis
Question: What does C.P.P and V.P.T stand for
(clue - neuro)
Answer: C.P.P = Cutaneous Pressure Perception
V.P.T = Vibration Perception Threshold
Question: What does MRSA stand for
Answer: Methicillin-resistant Staphylococcus aureus
Question: What does PNA and TNA stand for
Answer: PNA - Partial Nail Avulsion TNA - Total Nail Avulsion
Objective Assessments
Question: Name the neurological assessments you have completed
Answer: MonofilamentBiosthesiometer
Achilles reflex
Babinksi Reflex
Patella Reflex
Question: Is the biosthesiometer used to detect if a patient is at risk of ulceration - how?
Answer: Yes - by testing deep nerve fibers for sensory change
Question: Motor Neuropathy is described as
Answer: Weakness of intrinsic muscles causing imbalance
Results in claw toe deformity and prominent metatarsal heads
Often leads to callus and corns on apices of toes and metatarsal head area
Eventually ulceration due to unperceived micro trauma
Question: What does the following term meanAllodynia
Hyperalgesia
Cold Hyperalgesia
Heat Hyperalgesia
Answer: • Allodynia – painful sensation from non-painful stimuli OR loss of
perception to light touch
• Hyperalgesia – enhanced response to sharp pricking stimuli
• Cold hyperalgesia – loss or enhanced cold sensation
• Heat hyperalgesia – loss or enhanced heat sensation
Question: When conducting the objective testing what are the protocols should be observed: (4)
Answer:
• Explain to patient what assessments you intend to perform and the reasons for
performing each particular test.
• Obtain patient verbal consent to begin physical examination/assessment.
• Collect all required equipment before beginning.
• Explain the results of each assessment to the patient in laypersons terms.
Lucky Dip
Question: What are the names of my 2 children
Answer: Michelle Ashleigh
Question: What was the final netball score between Aus and NZ played on Saturday night
Answer: 47-34 Australia
Question: If someone suffers from podophobia what are they scared of
Answer: Feet
Question: What day of the Week will Christmas be on this year
Answer: Thursday
Question: What is the Maori word for Feet
Answer: Wae Wae