A 45yo man is admitted to ED with excruciating pain in the right leg. Exam: limb is pale and
dorsalis pedis and posterior tibial pulses are absent. Pulse=88bpm, irregular and he has a
pansystolic murmur at apex. What is the most probable dx?
a. Thromboangitis Obliterans
b. Sciatica
c. DVT
d. Atherosclerosis
e. Embolus
answer: E
Loss of distal pulses, pale, painful = interruption of limb's blood supply, source of embolus likely to be AF.
DVT interrupts the veins, clinical picture is much more subtle with swelling, local tenderness, no loss of distal pulses
Sciatica is a nerve disorder, no local signs such as pallor, loss of pulse
Atherosclerosis and T.O are not acute diseases.
No comments:
Post a Comment