Acutely painful limb and Ulcers Flashcards
1
Q
Acute painful limb that is cold and pale?
A
- Treat as acute limb ischaemia until proven otherwise
- Surgical emergency
2
Q
Acute limb ischaemia 6 P’s
A
- Pain
- Pallor
- Pulselessness
- Parasthesia
- Perishingly cold
- Paralysis
Most patients just present with pain, pallor and pulselessness
3
Q
RF for acute limb ischaemia
A
- AF
- HTN
- Smoking
- Diabetes
- Recent MI
4
Q
Investigation for acute limb ischaemia
A
- CT angiogram
- = confirm and locate where –> urgent vascular review
5
Q
Management acute limb ischaemia
A
- Urgent vascular review
- Fluid resucitation
- IV heparin while awaiting management
- Irreversible tissue damage occurs within 6 hrs
6
Q
Sudden hot, painful and swollen limb?
A
- Assess for potential DVT
- Pain often localised to calf
- Calves tender and firm
7
Q
Management DVT suspected
A
- Calculate Wells score
- If score 2 points or more, DVT likely so need US doppler
- If 0 or 1, can do D-dimer
8
Q
Treatment DVT
A
- Initial LMWH therapeutic dose
- Then swap to DOAC
- If iliofemoral, need urgent vascular review
9
Q
Other causes hot swollen painful limbs
A
- Cellulitis
10
Q
What can iliofemoral DVT presen with?
A
- Entire leg swelling
- Phlegmasia cerulea dolens - blue leg
- Phlegmasia alba dolens - white leg
11
Q
What to check for trauma as cause for acutely painful limb?
A
- Focal bony tenderness
- Inability to weight bear
- –> radiological imaging
12
Q
When to suspect radiculopathy for acute painful limb?
A
- Back pain that radiates
- Worse on movement
- Muscle weakness
- Parasthesia
- Altered reflexes
13
Q
Cut off APBI for compression bandaging for venous ulcers
A
- Needs to be greater than 0.6 before any bandaging is applied
