acute limb threat

Question 1

what triad of pathologies does this encompass

Answer 1

acute limb ischaemia, acute on chronic limb ischaemia and diabetic foot sepsis

Question 2

what is acute limb ischaemia

Answer 2

sudden loss of blood supply to a limb

Question 3

how can acute limb ischaemia occur

Answer 3

occlusion of artery or occlusion of a bypass graft

• embolism
• arterial dissection
• trauma
• extrinsic compression

Question 4

CF of acute limb ischaemia

Answer 4

pain
pallor 
pulseless 
perishingly cold 
paresthesia
paralysis

Question 5

what does woody feel indicate

Answer 5

muscle necrosis

Question 6

describe the pain in acute limb ischaemia

Answer 6

severe sudden and analgesia resistant

Question 7

what is paraesthesia and paralysis indicative of in acute limb ischaemia

Answer 7

muscle and nerve ischaemia

Question 8

acute limb ischaemia investigation

Answer 8

ABC
U and E
CK test 
eCG 
CXR

Question 9

what does ECG show in acute limb ischaemia

Answer 9

MI or dysrrhythmia

Question 10

what does CXR look for in acute limb ischaemia

Answer 10

underlying malignancy

Question 11

in acute limb ischaemia what pharmacological intervention might u consider

Answer 11

anticoagulation

- slow down propagation of thrombus and allow time for perfusion of limb to improve

Question 12

acute limb ischaemia - imaging

Answer 12

arterial imaging

Question 13

when to give arterial imaging in acute limb ischaemia

Answer 13

if no prior history of claudication, cause for embolism known or full complement of contra lateral pulses

Question 14

if there is doubt about the history in acute limb ischaemia what imaging would you perform

Answer 14

CT angiogram or catheter angiogram

Question 15

acute limb ischaemia - limb salvageable

Answer 15

embolectomy, fasciotomy and thromboylsis

Question 16

acute limb ischaemia - limb not salvageable

Answer 16

palliation or amputation

Question 17

what does thrombolysis do

Answer 17

dissolve the clot