Nokea
A 61-year old female patient with diabetes is in the emergency department after stepping on a sharp onject while walking barefoot on the beach. The patient did not notice that the object pierced the skin unitl later that evening. What problem does she probably have?
Correct Answer: A
Rationale: The patient's presentation of stepping on a sharp object and not noticing the injury until later is suggestive of peripheral neuropathy, a common complication of long-standing diabetes. Peripheral neuropathy can decrease sensation in the feet, making the patient more susceptible to injuries. In diabetes, high blood sugar levels can damage the nerves throughout the body, particularly those in the extremities. This can result in decreased sensation and poor wound healing, putting the patient at risk for injuries like stepping on a sharp object without feeling it. Therefore, the likely problem the patient has is neuropathy affecting her peripheral nerves.