CCs - in brief

Question 1

What are the complications of femoral emboli?

Answer 1

Acute limb ischaemia
22% mortality
16% amputation

Question 2

What are the 6 Ps of acute ischaemia?

Answer 2

Pale
Pulseless
Painful
Paralysed
Paraesthetic
Perishingly cold

Question 3

How do you manage acute limb ischaemia?

Answer 3

Urgent surgical revascularisation within 4-6h via open surgery or angioplasty
Anticoagulate with heparin after surgery

Question 4

How would the limb of a patient with known PAD appear?

Answer 4

‘Deep duskiness’ of limb –> acute arterial occlusion
Sudden deterioration of symptoms
Careful not to misdiagnose as gout / cellulitis

Question 5

What is Leriche syndrome?

Answer 5

A form of peripheral arterial disease affecting the aortic bifurcation
Presents specifically with buttock or thigh pain
Associated with erectile dysfunction

Question 6

What are the 3 ways in which critical limb ischaemia can be clinically defined?

Answer 6

1. Ischaemic rest pain for >2 weeks duration, requiring opiate analgesia
2. Presence of ischaemic lesions or gangrene attributable to arterial disease
3. ABPI less than 0.5 (>0.9 is normal)

Question 7

What are the two main differential diagnoses for a patient presenting with limb ischaemia symptoms?

Answer 7

Spinal stenosis - pain radiation from back down lateral aspect of leg, relieved by sitting
Acute limb ischaemia