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 ischaemia1.3 = 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 controlVasodilators (e.g. naftidrofuryl oxalate) for claudicationPain 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/arterial-ulcers-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/arterial-ulcers-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/arterial-ulcers-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/arterial-ulcers-rapid-quiz/🧪 Topic Quiz:https://www.passthemsra.com/quizzes/arterial-ulcers/🎓 Full Course:https://www.passthemsra.com/courses/dermatology-for-the-msra/📣 All resources are part of the Dermatology for the MSRA course athttps://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