Chronic venous insufficiency

Question 1

when does chronic venous insufficiency occur

Answer 1

when blood doesn’t efficiently drain from legs back to heart

usually due to damaged vein valves (age, immobility, obesity, DVT)

Question 2

skin changes due to blood pooling in gaiter area

Answer 2

haemosiderin staining
venous ezema
lipodermatosclerosis
atrophie balance

Question 3

Management involves

Answer 3

keeping skin healthly
improve venous drainage of legs
managing complications

Question 4

Mx - keeping skin healthy

Answer 4

• monitor skin health and avoid damage
• emolients
• topical steroids for venous eczema flares

Question 5

Mx - improving venous drainage

Answer 5

weight loss
keep active
elevate legs when resting
compression stockings once arterial disease excluded

Question 6

Mx - complications

Answer 6

antibx
analgesia
wound care - ulcers

Question 7

how to rule out artieral disease

Answer 7

ankle brachial pressure index

Question 8

haemosiderin statning

Answer 8

red/brown discouloration due to Hb leaking into skin

Question 9

venous eczema

Answer 9

dry, itchy, flaky, scaly red cracked skin

due to chronic inflammatory response in skin

Question 10

Lipodermatosclerosis

Answer 10

hardening + tightening of skin and tissue between skin

subcutaneous tissue becomes fribrotic

Question 11

atophie blache

Answer 11

patches of smooth skin, porcelain-white scar tissue

surrounded by hyperpigmentation