peripheral arterial disease

Question 1

features of intermittent claudication

Answer 1

aching or burning in the leg muscles following walking
usually relieved within minutes
not present at rest

Question 2

investigations for intermittent claudication

Answer 2

check femoral, popliteal, posterior tibialis and dorsalis pedis pulses
check ABPI
duplex

Question 3

presentation of acute limb ischaemia

Answer 3

pale
pulseless
painful
paralysed
paraesthetic
perishingly cold

Question 4

investigations for acute limb ischaemia

Answer 4

handheld arterial doppler
CT angio

Question 5

initial management of acute limb ischaemia

Answer 5

A-E assessment
IV opioids
IV unfractionated heparin
vascular review

Question 6

definitive management of peripheral arterial disease

Answer 6

intra-arterial thrombolysis
surgical embolectomy
angioplasty
bypass surgery
amputation

Question 7

presentation of life-threatening limb ischaemia

Answer 7

rest pain in foot for more than 2 weeks
ulceration
gangrene
patients report hanging their legs out of bed at night ease pain/ sleep in chair

Question 8

medical optimisation

Answer 8

atorvastatin 80mg
clopidogrel (aspirin if not tolerated)
quit smoking
exercise
analgesia
control co-morbidities

Question 9

management of severe PAD or life-threatening ischaemia

Answer 9

endovascular revascularisation
- angioplasty/ stent
open surgical revascularisation