Derm: Arterial Ulcers: Free MSRA Podcast скачать в хорошем качестве

Derm: Arterial Ulcers: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Arterial Ulcers 🎧 A clear, high-yield breakdown of this ischaemic wound caused by poor arterial blood flow – perfect for exam prep and real-life clinical scenarios. 🧠 Key Learning Points 📌 Definition • Arterial ulcers (aka ischaemic ulcers) are chronic wounds caused by inadequate blood supply, commonly affecting the lower legs, feet, or toes. 📌 Causes & Risk Factors • Peripheral arterial disease (PAD) from atherosclerosis • Smoking, diabetes, hypertension, hyperlipidaemia • Coronary artery disease, stroke/TIA history • Obesity, immobility, older age, family history of vascular disease 🧠 Mnemonic: “SHOD CHIP” – Smoking, Hypertension, Obesity, Diabetes, Cholesterol, History (stroke/PAD), Increasing age, Poor circulation 📌 Pathophysiology • Reduced arterial blood flow → poor oxygen/nutrient delivery • Tissue unable to heal minor trauma → ulceration • Common in pressure areas (heels, malleoli, toes) 📌 Symptoms • Pain – burning, worse at night or with elevation • Intermittent claudication – pain with walking, relieved by rest • Cold, pale limb; hair loss; thickened nails • Punched-out ulcers with well-defined edges and black necrotic base 📌 Differential Diagnosis • Venous ulcers (most common) • Diabetic ulcers (neuropathic or mixed) • Pressure ulcers, vasculitic ulcers, hypertensive ulcers • Malignancy (e.g. Marjolin’s ulcer), metabolic causes 📌 Diagnosis • Clinical assessment – absent pulses, cold/pale limb, ulcer appearance • ABPI (Ankle Brachial Pressure Index) • ＜ 0.9 = PAD • ＜ 0.5 = critical limb ischaemia • 1.3 = may indicate arterial calcification (e.g. in diabetes) • Buerger’s test, cap refill, duplex ultrasound • Bloods: FBC, HbA1c, lipids, U&Es, ESR, autoantibodies • ECG for AF; swabs if infected 🧠 Mnemonic: “6 Ps of PVD” – Pain, Pallor, Pulselessness, Paraesthesia, Paralysis, Poikilothermia (coldness) 📌 Management • NO compression therapy – contraindicated if ABPI ＜ 0.5 • Improve perfusion – smoking cessation, exercise therapy • Medications: • Antiplatelets (Clopidogrel 1st line) • Statins (e.g. atorvastatin) • ACE inhibitors, diabetes control • Vasodilators (e.g. naftidrofuryl oxalate) for claudication • Pain relief: opioids for rest pain • Wound care: debridement, appropriate dressings • Revascularisation: angioplasty or bypass surgery • Referral: if ABPI ＜ 0.5, ＞ 1.3, non-healing, suspected malignancy, or comorbidities 📌 Complications • Infection – cellulitis, osteomyelitis • Gangrene, limb loss • Chronic pain, reduced mobility • Sepsis, neuropathy • Significant psychosocial impact 📌 Prognosis • Depends on ulcer size, PAD severity, comorbidities, and access to care • Healing can be prolonged • Recurrence is common • Delayed diagnosis and poor compliance → worse outcomes 📎 More MSRA Resources for Arterial Ulcers 📝 Revision Notes: https://www.passthemsra.com/topic/art... 🧠 Flashcards: https://www.passthemsra.com/topic/art... 💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/art... 🚀 Rapid Quiz: https://www.passthemsra.com/topic/art... 🧪 Topic Quiz: https://www.passthemsra.com/quizzes/a... 🎓 Full Course: https://www.passthemsra.com/courses/d... 📣 All resources are part of the Dermatology for the MSRA course at https://www.passthemsra.com – your high-yield, NICE-based revision hub 🚀 Hashtags #MSRA #MSRARevisionNotes #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #ArterialUlcers #PeripheralArterialDisease #Dermatology