Vascular

Question 1

What is the cause of venous ulcers?

Answer 1

Pooling of the blood and waste products in the skin secondary to venous insufficiency.

Question 2

Typical features of arterial ulcers:

Answer 2

• Small
• Deep
• Well-defined borders
• ‘Punched-out’ appearance
• Very painful
• Pain worse at night (when lying horizontal) and on elevation
• Unlikely to bleed

Question 3

Typical features of venous ulcers:

Answer 3

• Occurs between top of food and bottom of calf muscle (gaiter area)
• Hyperpigmentation
• Large
• Superficial
• Irregular, gently slowing border
• Likely to bleed
• Little pain
• Pain worse on lowering leg
• Pain relieved on elevation
• Lipodermatosclerosis (acute or chronic)

Question 4

Management of venous ulcer:

Answer 4

1. Cleaning
2. Debridement (removing dead tissue)
3. Dressing

Also compression therapy and pentoxifylline

Question 5

Classic location of venous ulcer?

Answer 5

Over the lateral and/or medial malleoli

Question 6

“Painful, hardened, tight, red or brown skin, which if circumferentially affecting the ankle area may eventually result in the leg having an ‘inverted champagne bottle’ or ‘bowling pin’ appearance.” is describing what?

Answer 6

Chronic lipodermatosclerosis

Question 7

What is the long-term thrombolysis management for patients with mechanical valve replacements?

Answer 7

Warfarin and aspirin

Question 8

What is the long-term thrombolysis management for patients with tissue valve replacements?

Answer 8

DOAC