Wound Care Certified Certification (WCC) Practice Exam

What is the MOST likely etiology of an ulcer at the medial malleolus with raised margins and deep base?

1. Venous ulceration

2. Sickle cell ulceration

3. Diabetic ulceration

4. Pressure ulceration

The correct answer is: Sickle cell ulceration

The scenario describes an ulcer located at the medial malleolus, which is a common site for venous ulcers, particularly in individuals with chronic venous insufficiency. The characteristics of raised margins and a deep base further indicate that this type of ulcer is likely associated with venous hypertension, resulting in poor blood flow and the formation of tissue damage. Venous ulcers typically present with irregularly shaped wounds that may appear shallow or deep, depending on the stage of chronic venous disease. The raised margins suggest that there is some degree of inflammation and tissue edema, which is often associated with the venous stasis that leads to ulcer formation in this area. Sickle cell ulceration, while possible, would more commonly present in different locations and under different circumstances related to the disease process, like vaso-occlusive crises leading to ischemia, rather than as a chronic non-healing ulcer at a specific anatomical location like the medial malleolus. Diabetic ulcers generally develop on the feet or toes due to neuropathy and pressure, and pressure ulcers are typically found over bony prominences. Therefore, the characteristics of the ulcer in question align more with the etiology of a venous ulcer, making it the most likely cause for the ulcer described in