The patient with atraumatic leg pain

Question 1

What are the 6 P’s of ischaemia?

Answer 1

Pain, parasthesia, paralysis, pallor, pulseless, perishingly cold

Question 2

When should hospital admission be considered for cellulitis?

Answer 2

Rapidly spreading area of infection, temp > 38o, systemic illness/vomiting, confusion, raised HR/RR, dizziness, facial infection/orbital cellulitis, immunocompromised, DM or other significant co-morbidities, lymphoedema, infant < 1 year, failure to respond to initial oral Abx

Question 3

What scoring system is used in DVT to guide management?

Answer 3

Wells’ score

Question 4

What test should be done if the Wells’ score is < 2?

Answer 4

D-dimer - a negative test will confirm the problem is not a DVT

Question 5

What test will diagnose DVT?

Answer 5

Ultrasound leg

Question 6

What is the management of gout?

Answer 6

Acute/pain relief: 
1st line = Naproxen or other NSAID. 2nd line = Colchicine. 
Recurrent gout (2-3 weeks post episode): 1st line = Allopurinol + naproxen. 2nd line = Febuxostat + naproxen