Initial information Second information Questions A 64 yo obe

A 64 yo obese female with a 10 year history of NIDDM (non-insulin dependent diabetes mellitus) presents to the clinic with chief complaint of \"a sore on the top of my foot\". The patient states that the \"sore\" has been present for 2 weeks and that she has been \"watching and cleaning it.\" The last 3 days, she has noted that her foot is becoming somewhat \"red and warm\". She also reports malaise and some \"blurriness\" in here vision. Presently, the patient is taking Metformin and has recently been placed on Humulin in the am because \"her sugars were running high\". She also takes Metoprolol for HTN. On examination, the BP is 142/94, temperature is 101 and a glucose reading is 326. There is a 2cm ulcer on the dorsal medial aspect of the L foot at the medial cuneiform with some \"greenish discoloration\". There is no other \"drainage\" from the area. The foot overall is mildly edematous with erythema (redness) of the skin surrounding the ulcer and extending over the dorsum of the foot. She is admitted to the hospital with a diagnosis of cellulitis of the L foot secondary to ulcer formation.

Solution

14)Reduced arterial flow and impaired venous outflow.

15)Blockage in small blood vessels of the foot -> reduced arterial flow -> decreased supply of oxygen and glucose to the toes -> discoloration.