Mock 10

Clinical Scenario for Role Play: Management of Venous Ulcer with Comorbidities

Background Information:

• You are a general practitioner in a community clinic.
• Mrs. Rosemary Glossop, aged 72, presents with concerns about her recently diagnosed right leg venous ulcer.
• Her medical history is significant for diabetes and hypertension, which are important considerations in the management of her leg condition.

Patient Profile:

• Female, 72 years old.
• Recent diagnosis of a right leg venous ulcer.
• Past medical history includes diabetes and hypertension.

Scenario Setup:

• Mrs. Glossop is concerned about the healing of her leg ulcer and the impact of her chronic conditions on her leg health.
• The doctor's task is to assess the current status of the ulcer, provide education on effective management strategies, and address her concerns, especially in the context of her diabetes and hypertension.

Patient Prompts:

1. Expression of Concern:

   • Mrs. Glossop might start with, "I'm worried about this ulcer on my leg not healing. With my sugar and blood pressure, is there something more I should be doing?"

2. Seeking Guidance:

   • She could also ask, "What can I do to help my leg get better? Are there treatments that can speed up healing?"

Clinchers:

• Discussing Impact of Comorbidities on Healing:
  • "Your diabetes and hypertension can slow down the healing process, but with proper management, we can improve the healing time and reduce complications."

Important Points to Keep in Mind:

• Comprehensive Assessment:

  • Examine the ulcer to assess its size, depth, and signs of infection. Review any treatments already initiated and their effectiveness.
  • Consider the need for referral to a wound care specialist or a vascular surgeon, especially if the ulcer shows signs of poor healing.

• Management of Diabetes and Hypertension:

  • Emphasize the importance of controlling blood sugar levels and blood pressure in promoting wound healing and preventing further complications.
  • Review her current medications for diabetes and hypertension; adjust if necessary to optimize her overall health and ulcer management.

• Education on Ulcer Care:

  • Provide detailed instructions on wound care, including cleaning, dressing changes, and signs of infection to watch for.
  • Discuss lifestyle modifications, such as diet and physical activity, that support her general health and specific conditions.

• Venous Ulcer Specific Treatment:

  • Discuss compression therapy, a mainstay of treatment for venous ulcers, to reduce swelling and improve blood flow.
  • Consider the potential need for advanced therapies like negative pressure wound therapy or skin grafting if conventional treatments are ineffective.

Expected from the Doctor:

• Clear Communication:

  • Use clear, simple language to explain how diabetes and hypertension affect wound healing. Ensure Mrs. Glossop understands her treatment plan and the reasons behind each recommendation.

• Reassurance and Support:

  • Provide emotional support and reassurance, acknowledging her concerns about her health and the impact of her chronic conditions.

• Coordination of Care:

  • Arrange for follow-up appointments to monitor the ulcer's healing progress and her diabetes and hypertension management.
  • Coordinate with specialists as needed to provide a multidisciplinary approach to her care.

This scenario tests the candidate's ability to integrate knowledge of chronic disease management with the specific treatment of venous ulcers, emphasizing patient education, interdisciplinary care, and empathetic communication.