Cardiovascular · UKMLA & AKT
Venous insufficiency (including varicose veins)
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise venous insufficiency (including varicose veins) — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Visible dilated veins - tortuous superficial veins along medial thigh/calf (great saphenous) or posterolateral calf (small saphenous)
- Heaviness/aching - worse after prolonged standing, improves with leg elevation
- Ankle oedema - pitting, worse at end of day, relieved overnight
- Skin changes of CVI - haemosiderin pigmentation (brown, gaiter area), venous eczema, lipodermatosclerosis (firm woody induration, inverted-champagne-bottle deformity)
- Venous ulceration - shallow, irregular margins, sloughy base, medial gaiter area above medial malleolus; usually painless unless infected
- Superficial thrombophlebitis - tender, erythematous, indurated segment along a varicosity
Lipodermatosclerosis vs cellulitis: lipodermatosclerosis is bilateral, chronic, non-tender, firm and woody; cellulitis is unilateral, acute, warm, tender, with systemic features (fever, raised WBC/CRP).
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