Acute Limb Ischaemia – Post Test

What is the 30-day mortality following an episode of acute limb ischaemia?

What is the chance of limb salvage following an episode of acute limb ischaemia?

An obese 80-year-old female presents with a 6-hour history of a cold, painful left leg. On examination, she is found to have an irregular pulse, her left leg is white with a palpable weak femoral pulse, but no pulses palpable distal to this. Her right leg is slightly warmer and she has palpable pedal pulses on that side.

What is the most likely underlying pathology?

A 67-year-old male presents with an acutely ischaemic right leg.

Which one of the following findings on examination indicate irreversible ischaemia?

A 59-year-old male presents with an ischaemic left leg.

Which one of the following findings suggests that this needs urgent revascularisation?

A 92-year-old nursing home resident with multi-infarct dementia is noted by the nursing staff to have a black toe and is referred by the general practitioner to the emergency department. On examination, she is apyrexial with a dry black first and second toe on her right foot with some erythema on her forefoot. She has palpable femoral pulses bilaterally but no pulses distal to this on either side. On Doppler examination, she has a weak posterior tibial signal on the right, and weak posterior tibial and anterior tibial signals on the left.

Which one of the following alternatives would be an appropriate initial management strategy?

A 19-year-old student presents to the emergency department on Saturday morning unable to move his right arm. He was out celebrating on Friday night and fell asleep with his arms over the back of a chair. On examination, he is unable to extend his right wrist and has numbness over the back of his hand but has a palpable radial pulse.

Which one of the following is the most likely diagnosis?

In a patient presenting with a suspected acutely ischaemic leg, when should you give a stat dose of 5000 units of intravenous heparin?

A 61-year-old diabetic with a history of claudication presents with a 2-day history of increasing pain in his right foot. On examination, you find he has a palpable right femoral pulse but no pulses distally. His foot is cool and pale with a weak dorsalis paedis Doppler signal. He has some reduced sensation over his forefoot but no weakness and no calf tenderness.

Which one of the following statements is true?

A 56-year-old man presents with a 5-day history of pain in his left calf on walking 50 yards. The pain is relieved quickly on stopping walking and he has no pain at rest. Two years ago, he had a below-knee amputation in his right leg following emergency vascular surgery, and he now walks with a prosthesis on that side. On examination, he has good femoral and prominent popliteal pulses although you cannot feel any pulses distal to this, but he has an audible arterial Doppler signal in his anterior tibial artery.

Which one of the following is the most appropriate course of action?