Leg ulcers: Clinical (To be retired)


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Leg ulcers: Clinical (To be retired)

Medicine and surgery

Allergy and immunology

Antihistamines for allergies


Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications


Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics


Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications



Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs


Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Non-biologic disease modifying anti-rheumatic drugs (DMARDs)

Osteoporosis medications


Leg ulcers: Clinical (To be retired)

USMLE® Step 2 questions

0 / 2 complete


USMLE® Step 2 style questions USMLE

of complete

 A 34-year-old man presents to the emergency department for evaluation of pain in the right lower extremity. The patient was running on the beach without shoes over the past weekend and sustained a small laceration to the bottom of the foot. Over the past 24 hours, he has been experiencing severe pain and swelling of the foot to the point that he is unable to bear weight. He is otherwise healthy and does not smoke, consume alcohol, or use illicit substances. Temperature is 38.6°C (101.5°F), pulse is 109/min, respirations are 22/min, and blood pressure is 131/72 mmHg. On physical examination, a 3 cm x 3 cm area of erythema is noted on the underside of the right foot. The patient is exquisitely tender to palpation over the entire aspect of the right foot extending to the mid tibia. A radiograph of the right foot is obtained and demonstrates the following finding:

Reproduced from: Radiopaedia

Which of the following is the most appropriate treatment for this patient’s clinical condition?  


Content Reviewers

Rishi Desai, MD, MPH


Antonella Melani, MD

Sam Gillespie, BSc

Tanner Marshall, MS

An ulcer is an unhealed sore or open wound that may appear on the skin or mucosal surfaces due to destruction of the epidermis that extends into the dermis and may reach subcutaneous fat or deeper tissues.

Skin ulcers may take a very long time to heal. For optimal wound healing, the wound bed needs to be well vascularized, free of devitalized tissue, clear of infection, and moist.

The general approach to treating any ulcer starts from wound debridement to remove the accumulation of devitalized tissue, as well as decreasing the bacterial load to prevent infections.

This is usually done through irrigation, typically warm isotonic saline solution; while surgical debridement with a scalpel or other sharp instruments is done for removing large areas of necrotic tissue, for chronic non healing ulcers, or when there are signs of infection.

In addition, individuals with infected ulcers should have wound cultures sent and should get started on antibiotic therapy.

Then, a dressing is applied to the ulcer to help the wound heal more quickly by providing a sterile, breathable and moist environment, as well as reducing the risk of infection. Dressings are typically changed daily or every other day.

Nonhealing ulcers may progress to gangrene, which is a hard, dry texture, usually in the distal toes and fingers, often with a clear demarcation between viable and black, necrotic tissue.

When gangrene has set in, aggressive debridement or amputation of the affected area may be required.

Skin ulcers most often appear on the legs, and can result from multiple causes.

Biopsies are not usually necessary for most ulcers, but can be helpful when the diagnosis is uncertain.

The most common causes are venous insufficiency, arterial insufficiency, and neuropathy. So they’re often classified as venous, arterial, or neuropathic.

Venous ulcers are associated with venous insufficiency due to valve dysfunction, which causes stasis of blood in the legs, and that leads to an increase in venous pressure. This in turn allows blood proteins and fluid to leak into the interstitial space.


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