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1. Define hemosiderin staining? - Correct Answer: leakage of RBCs which
have been broken down appears as a purple to brown staining
2. Define lipodermatosclerosis? - Correct Answer: hardening of soft tissue
where hemosiderin staining evolves into lipodermatosclerosis- found on
gaiter and sock areas and has appearance of inverted champagne bottle
3. Define atrophie blanche? - Correct Answer: smooth, white plaques of
think speckled atrophic tissue with tortous vessels on ankle or foot with
hemosiderin pigmented border
4. Define venous dermatitis? - Correct Answer: characterized by scaling,
crusting, weeping, erythema, erosions, and intense itching.
5. Differentiate dermatitis from cellulitis? - Correct Answer: In cellulitis,
patients will often exhibit pain, fever, tenderness, one or few bullae, no
, relevent history, no crusting, blood cxs usually negative, no lesions
anywhere else other than localized area, and high WBC count
6. What factors impede healing in venous ulcers? - Correct Answer: DM,
tobacco, malnutrition, umplanned weight loss, and meds (corticosteroids)
7. What is the most effective managment of CVI? - Correct Answer:
therapeutic compressions (30-40mmHg)
8. What should you do before deciding to tx with compressions? - Correct
Answer: rule out LEAD, by obtaing an ABI
9. What are the interpretations of ABI? - Correct Answer: ABI of 1.0 is pure
LEVD
10.ABI of 0.9 or less is LEAD
11.ABI of 0.5 or less is ischemia
12.When should you obtain an TBI? - Correct Answer: when ABI is >1.3
indicating calcification of vessels which in turn reflects invalid data. A TBI of
< 0.7 indicates LEAD
13.What is the gold standard for evaluating valve failure and extent of reflux? -
Correct Answer: duplex ultra sound
14.What are some methods for manaing venous ulcers and CVI - Correct
Answer: limb elevation- >heart level for 1-2 hours/daily and during sleep,
, calf pump exercises or referral to PT for shuffling gait, weight control,
medications (diuretics, topical corticosteroids, Pentoxifylline (Trental), and
compression therapy
15.How does Pentoxifylline work and when is it appropriate? - Correct
Answer: reduces aggregation of platelets and WBC, reducing capillary
plugging and enhances blood flow. ordered when standard therapy is not
effective
16.When are elastic or inelastic compressions indicated? - Correct Answer:
elastic for patients who are sedenatary vs. inelastic for patients who are
amublatory
17.When are high pressure compressions (30-40mmgHg) indicated, when
assessing ABI? - Correct Answer: ABI>0.8 can use high compressions
18.when are compressions contraindicated? - Correct Answer: venous
thrombosis in LE w/ulcers and uncompensated heart failure
19.when is sustained (continuous) compression contraindicated? - Correct
Answer: in the presene of PVD with an ABI that is < or =0.6 or when ABI is
>0.5 but <0.8 is more appropriate
20.when is IPC (intermittent pneumatic compression)-dynamic compression
indicated? - Correct Answer: for patients with venous insufficiency and
ABI< or =0.5, for those who cannot tolerate sustained compression, as an
adjunct therapy to sustained therapy, those who are immobile
, 21.when is modified or lower compressions appropriate (23-30mmHg)? -
Correct Answer: when coexisting arterial disease is present
22.all patients with leg uclers should be screened for arterial disease using
what, initially? - Correct Answer: doppler which measures ABI; takes BP
in the arm and ankle and compares ratio
23.What are the attributes of short-stretch compression? - Correct Answer:
it's inelastic, sustained compression and provides a modified to therapeutic
level of pressure-reusable
24.What are the attributes of long-stretch compression? - Correct Answer:
same as short stretch except it's elastic (ex. Surepress)
25.what are the attributes of multi-layer compression? - Correct Answer:
sustained, elastic, disposable, and provides therapeutic to modified
pressure (ex. 3M w/coban)
26.what are the attributes of paste compression and problems associated with
it? - Correct Answer: sustained, inelastic, disposable, and provides
modified level of pressure;lacks absorptive property so skin has tendency to
macerate, patients are sensitive to calamine paste, slippage, poor fit, and
inablity to bathe.