Ulcers

Question 1

What is the definition of a leg ulcer

Answer 1

any break in the skin of the lower leg above the ankle present more than 4 weeks

Question 2

What are the causes of leg ulcers?

Answer 2

venous disease
arterial disease
rheumatoid arthritis
diabetic
mixed arterial and venous
malignant
hydrostatic-dependant limb

Question 3

What is the general difference in pain in venous and arterial disease?

Answer 3

venous tends to have neuropathic pain whilst arterial tends to have ischaemic pain

Question 4

What are important things to ask about in PMHx of leg ulcers?

Answer 4

varicose veins; DVT; clotting problems; peripheral vascular disease; arterial disease elsewhere; diabetes

Question 5

Where do venous ulcers tend to be found?

Answer 5

gaiter area; above malleoli

Question 6

What are features of venous ulcers?

Answer 6

haemosiderin staining (hyperpigmentation); varicose veins; lipodermatosclerosis; atrophie blanche

Question 7

What is the normal range in ABPI?

Answer 7

0.8-1.3

Question 8

What is seen in venous eczema?

Answer 8

hyperkeratotic; itchy; very dry
bilateral
scratch marks

Question 9

How can you differentiate between venous eczema and cellulitis?

Answer 9

venous eczema is bilateral whereas cellulitis is usualy unilateral

Question 10

What are the pressures created in 4 layer bandaging system?

Answer 10

40mmHg at ankle; 25mmHg below kneee

Question 11

How long should it take to heal ulcers with the 4 layer bandaging system?

Answer 11

12 weeks

Question 12

What is the difference in appearance of venous and arterial ulcers?

Answer 12

venous ulcers tend to have a shallow edge whereas arterial ulcers may have very sharp cliff like edges and can be described as being punched out

Question 13

Where do diabetic and arterial ulcers often present?

Answer 13

pressure sites such as the heel or on the feet