Vascular

Question 1

Venous ulcer features

Answer 1

Most secondary to chronic insufficiency

Features:

• oedema
• lipodermatosclerosis
• venous eczema
• haemosiderin deposits
• gaiter distribution
• painless

Question 2

Venous insufficiency causes

Answer 2

superficial - varicose veins

deep - DVT

Question 3

Management of venous ulcer

Answer 3

4 layer compression banding after exclusion of arterial disease or surgery

Consider skin graft if fail to heal after 12 weeks or >10 cm2

Question 4

Marjolin’s ulcer

Answer 4

Squamous cell carcinoma

• occurs at sites of chronic inflammation - burns, osteomyelitis
• mainly effect lower limb

Question 5

Arterial ulcers features

Answer 5

Occur on toes and heel
painful
cold with no palpable pulses
low ABPI measurements

Question 6

Neuropathic ulcers feautres

Answer 6

plantar surfaces of metatarsal head and plantar surface of hallux
Most common condition that leads to amputation in DM
Mx
- cushioned shoes to reduce callous formation

Question 7

Pyoderma gangrenosum

Answer 7

Assoicated with inflammatory bowel disease and RA
Can occur at stoma sites
Erythematous nodules or pustules which ulcerate

Question 8

Oesteomyelitis Ix

Answer 8

MRI

Question 9

RF for osteomyelitis

Answer 9

DM
Sickle cell anaemia
IVDU
Immunosuppression
EtOH

Question 10

Mx of Osteomyelitis

Answer 10

fluclox 6 weeks

clindamycin if penicillin allergic