Leg ulcers: Clinical (To be retired)
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Leg ulcers: Clinical (To be retired)
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Antihistamines for allergies
Glucocorticoids
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
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Lipid-lowering medications: Statins
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Diabetes mellitus: Clinical (To be retired)
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Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
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Hypoglycemics: Insulin secretagogues
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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
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Anemia: Clinical (To be retired)
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Urinary tract 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
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Miscellaneous antifungal medications
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Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
PDE5 inhibitors
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: 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
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Osteoporosis medications
The do's and don'ts of patient care
Sexual orientation and gender identity
Taking a good patient history
Empathetic listening for clinicians
How to deliver bad news
Abdominal trauma: Clinical (To be retired)
Postoperative evaluation: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Assessments
Leg ulcers: Clinical (To be retired)
USMLE® Step 2 questions
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Questions
USMLE® Step 2 style questions USMLE
of complete
Reproduced from: Radiopaedia
Which of the following is the most appropriate treatment for this patient’s clinical condition?
Memory Anchors and Partner Content
Transcript
Content Reviewers
Rishi Desai, MD, MPHAn 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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