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Year 3 Histories/Conditions > Leg Swelling - OSCE tutoring > Flashcards

Leg Swelling - OSCE tutoring Flashcards

1
Q

Differentials for UNILATERALY acutely swollen calf

A

DANCES:

DVT
Allergic response (to an insect bite)
Nectrotising fasciitis (note this isn't necessarily acute)
Cellulitis
Compartment syndrome
Erysipelas
Septic arthritis

Thrombophlebitis

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2
Q

Differentials for BILATERALY acutely swollen calf

A 
RHF
Lymphoedema
Venous insufficiency 
Pregnancy
Vasodilator drugs
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3
Q

Types of vasodilator drugs causing bilateral swollen calf

A

CCB
Anticoagulants (bruising)
Antibiotics (prophylactic)

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4
Q

DVT presentation

A

Painful red calf
Tender along course of deep veins
Pitting oedema

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5
Q

Risk factors for DVT causing hypercoagulable blood

A 
Trauma
Surgery
Pregnancy
IBD
Cancer
Obesity
OCP/HRT/Tamoxifen
FH/PMH
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6
Q

Risk factors for DVT causing vessel injury blood

A

Trauma
Surgery
COVID

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7
Q

Risk factors for DVT causing stasis

A

More than 3 days bed rest

Travel history

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8
Q

What symptoms would you ask about to rule out PE

A

Breathlessness
Chest pain
Haemoptysis

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9
Q

What is cellulitis?

A

Bacterial infection of deep layer of skin

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10
Q

What do you call bacterial infection of upper superficial layers of skin?

A

Erysipelas

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11
Q

What are some key features of cellulitis regarding: borders, appearance and what it can cause?

A

Less clearly defined areas of skin
Dark red/purple skin
Can produce pus

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12
Q

What are some key features of erysipelas regarding: borders, appearance and what it can cause?

A

Clearly defined borders of inflammation
Shiny light red swelling
Can cause blisters

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13
Q

Other features of cellulitis

A

Itchy, red, warm to touch, painful, tender, fever

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14
Q

Risk factors for cellulitis

A

Anything causing breaks or cuts in skin

Injury - cut, fracture, burn or scrape
Skin conditions - eczema, athlete’s foot and shingles

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15
Q

Risk factors for cellulitis

A

Anything causing breaks or cuts in skin

Injury - cut, fracture, burn or scrape
Skin conditions - eczema, athlete’s foot and shingles

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16
Q

PMH that predispose to cellulitis

A 
Diabetes
Leukemia
HIV
Aids
Hx of cellutisi
17
Q

What are they key symptoms of septic arthritis?

A 
Sudden onset
Severe join pain upon passive and active movement 
Joint restriction 
Redness around joint
Hot, tender joint 
Possible systemic unwellness (fever)
18
Q

Risk factors for septic arthritis?

A 
Joint trauma (incl. animal bites, surgery)
Artifical joints
IV drug use/point of entry for bacteria on skin
19
Q

PMH relevant to septic arthritis

A

Skin fragility:
Eczema
Psoriasis

Immunosuppression:
Diabetes
HIV
Steroids

Infections:
STIs
Gonorrhoea
UTI

20
Q

What is venous insufficiency?

A

Veins have trouble sending blood back to heart

21
Q

Symptoms of venous insufficiency

A

Swelling in lower legs

Aching/cramp that gets worse throughout day

22
Q

Signs of venous insufficiency

A

Swelling in lower legs, esp ankles
Varicose veins
Dry/scaly skin
Flaking/itching skin (due to build up of blood)
Skin discolouration and hyperpigmentation
Thickening of the skin
Ulcers/infection

23
Q

Why do you get ulcers/infection with venous insufficiency?

A

Damage to tiny vessels due to blood pooling causes inflammation of the skin
Also, you become more sensitive to minor trauma

24
Q

Varicose veins vs venous insufficiency

A

Varicose veins come before venous insufficiency

25
Q

Risk factors for venous insufficiency

A

Elderly
Female
Obesity

Anything that prevents backflow of blood to heart (outflow obstruction):

  • Pregnancy
  • PMH of DVT/clotting
  • Cancer
  • Valve damage (e.g. due to DVT/surgery/
26
Q

What is a complication of venous insufficiency?

A

Cellulitis (due to breaks in skin, secondary to dryness due to reduced oxygen supply to these areas)

27
Q

Varicose veins vs venous insufficiency

A

Varicose veins comes before venous insufficiency

Year 3 Histories/Conditions (20 decks)

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