Vasc

Question 1

Lipodermatosclerosis

Gaiter region (of leg)

Medial malleolus

Haemosiderin deposition

Answer 1

Venous ulcer

Question 2

Atherosclerosis/vasculitis

Punched out appearance

Low ABPI

Absent pulses

Shiny, hairless limb

Smoking/DM/CVD

Painful

Answer 2

Arterial ulcer

Question 3

Absent/reduced sensation

Trauma ∴ soles/heels/toes

Well perfused, deep, penetrating skin

Loss of reflexes

Diabetes

Answer 3

Neuropathic ulcer

Question 4

Nodulo-pustular ulcer on leg

Red/blue necrotic edge

IBD, alcoholic hepatitis

Answer 4

Pyoderma gangrenosum

Question 5

SCC from previous scar/burn/ulcer

War veteran

Irregular, raised edge, blood-stained

Discharge, painless

Answer 5

Marjolin’s ulcer

Question 6

Pale, pulseless, painful, perishingly cold

Paraesthesia, paralysis, amputation

Fixed flexion deformity, necrotic

Revascularise in 4-6h

ABPI should be between 1 and 1.3

Answer 6

Acute limb ischaemia

Question 7

Atherogenic emboli –> retinal artery

Black curtain over eye

Answer 7

Amaurosis fugax

Question 8

Venous insufficiency

Distended superficial veins

Answer 8

Varicose veins

Question 9

Site of local trauma + tissue infection

Swelling, erythema, vesicle and bullae formation over skin

Fever +/- D&V

Answer 9

Necrotising fasciitis

Question 10

Split in lining of tuica aorta

Rupture into pericardium –> tamponade

Answer 10

Aortic dissection

Question 11

Digital ischaemia – reflex vasospasm arterioles

Pallor –> cyanosis –> reactive hyperaemia

Assoc. with rheum. conditions, cervical rib, beta blockers and ergot alkaloids

Answer 11

Raynaud’s syndrome