Items 282 and 283
A 65-year-old insulin-dependent (type I) diabetic presents with a 24-hour history of fever (temperature 39.2 °C) and glycosuria.
He has a penetrating ulcer on the plantar aspect of the foot with edema on the dorsum of the foot.
Item 282
The most appropriate initial study would be
magnetic resonance imaging (MRI) of the foot
gallium scan of the foot
flow-directed Doppler studies
roentgenogram of the foot
femoral arteriogram
Item 283
The initial therapeutic approach should be
femorotibial bypass
Syme amputation
exploration and debridement of the ulcer
below-knee amputation
hyperbaric oxygen therapy
For the incomplete statements above, select the one completion for each that is best of the five given.
For the critique of Items 282 and 283 see page 16.
Footnotes
(Reproduced by permission from SESAP ’94–’95 Syllabus; Surgical Education and Self-Assessment Program No. 8. For enrolment in the Surgical Education and Self-Assessment No. 8, please apply to the American College of Surgeons, 55 East Erie St., Chicago, IL 60611, USA.)