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A 58-Year-Old Man Comes to the Office for Evaluation of a Foot

question 805

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A 58-year-old man comes to the office for evaluation of a foot wound.  The patient noticed a small ulcer on the bottom of his right foot a week ago but recalls no significant foot injury.  He has been applying antiseptics, but the wound has failed to heal.  The patient has a 15-year history of type 2 diabetes mellitus and is nonadherent to medical therapy.  He has smoked a pack of cigarettes daily for 20 years.  Temperature is 37.1 C (98.8 F) , blood pressure is 140/80 mm Hg, and pulse is 72/min.  Right lower extremity examination shows a 1-cm (0.39-in) plantar ulcer under the first metatarsal head.  There are no other lesions, and the tibial and dorsalis pedis pulses are normal.  Which of the following is the major inciting factor responsible for this patient's foot ulcer?


Definitions:

Variability

Refers to the extent to which data points in a statistical distribution or dataset differ from the average or mean value.

Range

The difference between the highest and lowest values in a dataset, indicating the dataset's spread.

Outliers

Observations that are significantly different from, or lie outside, the main body of a distribution of data.

Standard Deviation

A metric that quantifies the degree of spread or variability among values in a collection.

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