Final answer:
The cold foot with reduced pedial pulse and increased pain upon elevation is indicative of an arterial ulcer, most likely caused by peripheral artery disease (PAD).
Step-by-step explanation:
The presentation of a cold foot with reduced pedial pulse and pain that increases upon elevation suggests an impairment in arterial blood supply, which is indicative of an arterial ulcer. Arterial ulcers are typically caused by peripheral artery disease (PAD), a condition characterized by the narrowing of peripheral arteries due to atherosclerosis, leading to decreased blood flow and ischemia. Venous ulcers, which usually occur due to venous insufficiency, often have a different presentation and generally improve with leg elevation. Diabetic ulcers are often neuropathic, caused by long-standing high blood sugar levels damaging nerves; though, they may also have an arterial component.
Given the symptoms described, the most likely answer to the question, "A patient presents with a cold foot with reduced pedial pulse. It is very painful, and when you elevate it, it hurts more. What is it?" is (c) arterial ulcer.