Week 3 - E - Leg ulcers Quiz Flashcards
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Venous ulcer
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0.9 (0.9-1.2 is normal ABPI)
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Lipodermatosclerosis
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None - of the above Dressings do not actually heal the ulcer, just necessary to cover it (non-adherent dressings)
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Arterial ulcer
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Slough is skin debris and dead bacteria
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Slough can be removed via Compression bandaging Hydrogels Manual debridement Also larvae (maggots)
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Only those showing signs of clinical infection - cellulitis, pyrexia, increased pain, rapid extension of area of ulceration, malodour, increased exudate
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Pseudomonas colonisation manufatcures a blue pigment
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Same for cleaning of other ulcers - warm tap water, soap substitute and dry
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Apply regular emollients and topical steroids Consider patch testing as the venous dermatitis may be due to chemicals in the eg dressing or compression sotcking
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In patients with chronic venous leg ulcers, systemic antibiotics should not be used unless there is evidence of clinical infection. Aspirin and pentoxyfylline are correct Pentoxifylline is believed to increase microcirculatory blood flow although the exact mechanism of action is unknown
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Skin cancer and inflammatory skin disease are correct
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All of the above
Which of these is a common site for venous ulcers * Shin * Calf * Medial and lateral malleoli
Shin is a common site for venous ulcer Gaiter area is most common - medial leg
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To assess the arterial system
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Mutlilayer (4 layer) compression bandage (40mmHg at ankle, roughly 25mmHg at below knee)
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Cone
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Compression bandaging is the most important therapy in healing venous leg ulcers
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Compression should be applied following DVT once the patient is fully anti-coagulated
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Patient should be advised to use regular emollient and wear appropriate strength compression stockings
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Compressions stockings should be replaced every 4-6 months
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Refer a patient with a chronic leg ulcer after 12 weeks of treatment if ineffective or if any suspicion of skin cancer
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SIGN Scottish inter-collegiate guidelines network
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Maggots