Legs and Feet

Question 1

What is acute limb ischaemia?

Answer 1

Suden loss of blood supply to a limb

Occlusion of native artery or bypass graft

Question 2

What are causes of acute limb ischaemia?

Answer 2

Embolism
Arterial dissection
Trauma
Extrinsic compression

Question 3

What are features of acute limb ischaemia?

Answer 3

Severe sudden analgesia-resistant pain in calf msucle
Pulseless
Cold
Paraesthesia 
Paralysis

Question 4

Paraesthesia is also known as?

Answer 4

Pins and Needles

Question 5

How do you treat acute limb ischaemia?

Answer 5

ABC resus
Intra-operative angiogram
If salvageable limb: embelectomy +/- fasciotomies +/- thrombolysis
If not: palliation / amputation

Question 6

What causes diabetic foot sepsis?

Answer 6

Neuropathy, peripheral vascular disease and infection can rapidly progress to sepsis in the interosseous fascia

Question 7

Diabetes foot sepsis is a?

Answer 7

surgical emergency

Question 8

What are clinical features of diabetic food sepsis?

Answer 8

Pyrexia
Tachycardia
Tachypnoea
Confusion
Kussmaul breathing
Swelling
Tenderness
Ulcer with pus
Erythema
Patches of necrosis
Crepitus in soft tissue of foot

Question 9

How do you treat diabetic foot sepsis?

Answer 9

Antibiotics + rapid surgical debridement of infected tissue
Remove all infected tissue
Wound open to encourage drainage