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Dermatology - Clinical Medicine IV > Ulcers > Flashcards

Flashcards in Ulcers Deck (56)
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1

What causes venous infufficiency?

varicose veins
incompetent venous valves

2

What causes incompetent venous valves?

thrombus formation or congenital

3

What are the risk factors for venous insufficiency?

Age
Obesity
Lifestyle
Sedentary; Occupation
Pregnancy
H/o DVT
Leg injury
Phlebitis
Female

4

Which one is more common: venous or arterioal insufficiency?

venous

5

What is the presentation of venous insufficiency?

Burning
Swelling
Throbbing
Cramping
Aching
Heaviness
Restless leg
Leg fatigue

6

What is seen on PE of venous insufficiency?

Edema
Varicose veins
Hyperpigmentation
Chronic cellulitis
Cutaneous infarction
Atrophie blanche
Lipodermatosclerosis
Stasis dermatitis
Ulceration

7

What are early signs of venous insufficiency?

statis dermatitis, inflammation of skin

8

What is lipdermatosis also called?

champagne bottle legs

9

Who gets stasis dermatitis more?

women, increase risk with age

10

What are signs and symptoms of stasis dermatitis?

Pruritis
Discoloration
Medial ankle involvement and progression to foot &/or calf
Edema

11

What are the treatments for stasis dermatitis?

Control venous insufficiency and edema
Compression
Ligation of vessels?

12

What ABX do you use for stasis derm?

topical for erosions
Oral if cellultis

13

What steroid do you use for stasis derm?

triamcinolone 0.1% ointment

14

What is most common of lower extremity ulcers?

venous ulcers

15

What are risk factors for venous ulcers?

Venous Insufficiency
Age
Obesity
Previous Leg injury
DVT
Phlebitis

16

Who gets venous ulcers more often?

>65 yo

17

How do you dx venous ulcers?

Ankle-brachial index
Ratio of BP at ankle to arm
Color duplex ultrasonography
Venography

18

Where do you see venous ulcers?

medial!

19

What is the treatment for venous ulcers?

Underlying Cause
Compression therapy
-Caution with arterial insufficiency
-Elastic
-Inelastic
---Unna boot: zinc oxide-impregnated, moist bandage that hardens after application
-Intermittent pneumatic compression
Leg elevation
Wound vac - negative pressure
Meds
Hyperbaric oygen therapy
surgery

20

What are the dressing types for venous ulcers?

Hydrocolloids
Hydrogels
Foams
Pastes
Simple nonadherent dressings

21

What meds can you use for venous ulcer treatment?

Pentoxifylline (Trental)
ASA
Iloprost
?? Oral Zinc
Antibiotics

22

What does pentoxifylline do?

Inhibits platelet aggregation, decreases blood viscosity and improves microcirculation

23

What is the surgical treatment for venous ulcers?

debridement, grafing, venous insufficiency

24

What is the treatment for venous insufficiency?

Vein ablation
Phlebectomy
Stripping
Sclerotherapy
Laser therapy

25

Look at chart in PPT

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26

What is the most common cause of arterial insufficiency?

atherosclerosis

27

What are the risk factors for atherosclerosis?

Cigarette smoking
Diabetes Mellitus
Dyslipidemia
Hypertension

28

What isi the signs and symptoms of arterial insufficiency?

Intermittent claudication
Progresses to resting pain/night pain
Pallor
Cyanosis
Livedoid vascular pattern
Loss of hair
Decreased pulses

29

What are 25% of leg ulcers?

arterial ulcers

30

What is the etiology of arterial ulcers?

Atherosclerosis
Diabetes
Thromboangiitis
Thalassemia
Sickle cell disease