FINALS: PVD

Question 1

What are the 6 P’s of arterial insufficiency?

Answer 1

Pain, paresthesia, poikilothermia, paralysis, pallor, pulselessness.

Question 2

What is intermittent claudication?

Answer 2

: Pain in the lower extremities during walking or exercise, relieved by rest.

Question 2

Which test distinguishes between vascular claudication and spinal stenosis?

Answer 2

Treadmill test:

Vascular: Pain relieved by rest.
Spinal stenosis: Pain relieved by leaning forward.

Question 3

What are common sites for arterial ulcers?

Answer 3

Lateral malleolus, toes, dorsum of foot, anterior tibial area.

Question 4

Q: What are common sites for venous ulcers?

Answer 4

medial malleolus

Question 5

Q: Describe the drainage difference between arterial and venous ulcers.

Answer 5

Arterial: Minimal, dry.
Venous: Moderate to heavy.

Question 5

Q: Which type of ulcer is associated with gangrene?

Answer 5

A: Arterial ulcers.

Question 6

Q: What is the most common site for pressure sores in wheelchair-bound patients?

Answer 6

A: Ischial tuberosities.

Question 7

Q: What are the stages of pressure ulcers?

Answer 7

Stage 1: Non-blanchable erythema, intact skin.
Stage 2: Partial thickness skin loss (epidermis/dermis).
Stage 3: Full thickness skin loss, subcutaneous tissue damage.
Stage 4: Full thickness skin loss, extensive destruction, necrosis.

Question 8

Q: Which pressure ulcer stage may lead to osteomyelitis?

Answer 8

A: Stage 4.

Question 9

Q: What is the gold standard for offloading neuropathic ulcers?

Answer 9

A: Total contact cast with rocker bottom.

Question 10

Q: Where are diabetic ulcers commonly found?

Answer 10

A: Plantar aspect of the foot or weight-bearing areas.

Question 11

Q: What does Wagner Scale Grade 3 indicate?

Answer 11

A: Osteitis, abscess, or osteomyelitis.

Question 12

Q: What is tunneling in wound assessment?

Answer 12

A: Extension of wound depth along a path.

Question 13

Q: Which color indicates healthy wound drainage: serous, sanguineous, or purulent?

Answer 13

A: Serous or sanguineous.

Question 14

Q: What is the Levine technique for acquiring a wound culture?

Answer 14

A: Swab a 1 cm² area free of necrotic tissue, applying pressure for 5 seconds.

Question 15

Q: What does a venous filling time of >15 seconds suggest?

Answer 15

A: Arterial insufficiency.

Question 16

Q: What is a positive Rubor of Dependency test?

Answer 16

A: Dark red skin taking >30 seconds to appear after lowering the limb (arterial insufficiency).

Question 17

Q: What does Homan’s sign test for?

Answer 17

A: Deep Vein Thrombosis (DVT).

Question 18

Q: What are the goals for wounds classified as “Yellow”?

Answer 18

A: Remove exudate and debris, absorb drainage.

Question 19

Q: What is the focus for “Red” wounds?

Answer 19

A: Protect and maintain a moist environment.

Question 20

Q: What Braden Scale score indicates high risk for pressure ulcers?

Answer 20

A: Scores of 10-12 (high risk).

Question 21

Q: What does a Wells score of >3 indicate?

Answer 21

A: High probability of DVT.

Question 22

: A 62-year-old male presents with a painful ulcer on the lateral malleolus, cold and pale foot, diminished dorsalis pedis pulse, and pain during walking relieved by rest.
Q: What test can confirm arterial insufficiency?
Q: What is a key treatment approach for this condition?

Answer 22

Q: What test can confirm arterial insufficiency?
A: Ankle-Brachial Index (ABI) <0.9 suggests arterial insufficiency.

Q: What is a key treatment approach for this condition?
A: Revascularization, smoking cessation, and management of risk factors (DM, HTN, dyslipidemia).

Question 23

A 50-year-old male with uncontrolled diabetes presents with a painless ulcer on the plantar surface of the foot, surrounded by callus, with dry and scaly skin.

Q: What is the likely type of ulcer?
Q: Why is the ulcer painless?

Answer 23

Neuropathic (diabetic) ulcer.
A: Peripheral neuropathy leads to loss of protective sensation.

Question 23

A 45-year-old sedentary male presents with unilateral calf swelling, redness, and pain aggravated by dorsiflexion of the foot.

Q: What test result supports DVT?

Answer 23

A: Positive Homan’s sign.

Question 24

A 70-year-old bedridden patient presents with a sacral ulcer showing full-thickness skin loss with tunneling but no exposed bone or muscle.

Q: What stage is this ulcer?
Q: What tool can assess this patient’s risk for developing more ulcers?

Answer 24

A: Stage 3.

A: Braden Scale (<18 indicates risk).

Question 25

A 55-year-old female presents with an irregular, shallow ulcer on the medial malleolus. The surrounding skin has reddish-brown discoloration, edema, and moderate drainage.

Q: What type of ulcer is this?
Q: What causes the reddish-brown discoloration?

Answer 25

Q: What type of ulcer is this?
A: Venous ulcer.

Q: What causes the reddish-brown discoloration?
A: Hemosiderin staining due to chronic venous insufficiency.