Cardiovascular · UKMLA & AKT
Venous insufficiency (including varicose veins)
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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