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General medicine > Limb pain/swelling > Flashcards

Limb pain/swelling Flashcards

1
Q

What are the differentials for an acute hot, swollen, and red leg?

A 
DVT
Cellulitis
Nec fasciitis 
Septic arthritis 
Contact dermatitis 
Drug reaction
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2
Q

Treatment for moderate cellulitis in patient?

A

IV fluclox 2g 6 hrly

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3
Q

Which antibiotic is recommended for moderate cellulitis and penicillin allergy?

A

IV vancomycin

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4
Q

What is the difference between cellulitis and erysipelas?

A

cellulitis= acute infection of deep subcutaneous tissue and dermis

Erysipelas= more superficial dermal and upper subcutaneous tissue infection, often affecting the face

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5
Q

Which is the most useful imaging modality in necrotising fasciitis?

A

MRI

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6
Q

What is the most common organism to cause nec fasciitis?

A

strep pyogenes

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7
Q

What are the risk factors for nec fasciitis?

A 
recent wound or bite
diabetes
immunocompromised
IVDU
Alcohol excess
CKD
NSAIDs
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8
Q

What are the investigations for nec fasc?

A

gram stain exudate
MRI/CT to delineate extent of NF
rapid strep diagnostic kit and PCR

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9
Q

What is the management of NF?

A

ICU
R/V infectious disease, surgery, orthopaedics
Broad spectrum abx
Debridement

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10
Q

Name five categories for the causes of limb pain

A
  1. MSK
  2. Joint pain
  3. Inflammatory
  4. Infective
  5. Vascular
  6. Neurological
  7. Malignant
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11
Q

Examples of MSK causes of limb pain?

A

bruising, soft tissue trauma, fractures

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12
Q

Examples of joint pain resulting in limb pain?

A

OA, meniscal injury

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13
Q

Inflammatory limb pain causes?

A

RA, polymyalgia rheumatica, dermatomyostitis

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14
Q

Infective causes of limb pain?

A

cellulitis, osteomyelitis

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15
Q

Vascular causes of limb pain?

A

arterial ischaemia, venous thrombosis

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16
Q

Neurological cause of limb pain?

A

radiculopathy

17
Q

Examples of conditions causing bilateral limb pain?

A

OA, RA, fibromyalgia, polymyalgia rheumatica

18
Q

Examples of causes of unilateral limb pain?

A

fracture, sarcoma, radiculopathy, cellulitis, venous thrombosis, osteomyelitis

19
Q

What are characteristic symptoms/signs of polymyalgia rheumatica?

A

Bilateral shoulder and/or pelvic girdle pain

Stiffness lasting for >45 mins after walking or periods of rest

Raised CRP and ESR

20
Q

What is the management for polymyalgia rheumatica?

A

prednisolone

21
Q

A patient has temporal arteritis. Who should you refer them to?

A

rheumatology

General medicine (6 decks)

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