Sign and Symptom Recognition
Diagnostic Reasoning
Diagnostic Interpretation
Physical Exam
100
Visible, twisted collection of veins
Varicosities
100
Suspected diagnosis for fever with localized extremity pain, redness, and swelling
What is cellulitis?
100
Gold standard diagnostic test for DVT
What is venous duplex (ultrasound)?
100
Normal capillary refill time
What is less than 2 seconds?
200
Exertional leg pain alleviated by rest
What is claudication?
200
Ddx for leg pain (list 3)
What is DVT, PAD, thrombophlebitis, MSK cause, cellulitis
200
Priority test for the patient with suspected claudication
What is arterial doppler/US?
200
What is lymphedema?
300
Numbness, pain, color change in affected area in response to cold or emotional stress
What is Raynaud's?
300
Virchow's triad
What is venous stasis, endothelial injury, hypercoagulability?
300
Priority tests for new onset extremity hair loss and and brittle fingernails (select 2)
TSH level, arterial US
300
In-office physical exam to assess for PAD
Ankle brachial index (ABI)
400
"Great toes blanch when lower extremities are extended and held superiorly to approximately 60° while lying supine. When extremities are lowered, the great toes return to their original color within 6 seconds."
Arterial insufficiency
400
Next best step for the patient with leg pain and positive ABI
What is arterial ultrasound?
400
Interpret an ABI of 0.8
What is abnormal?
ABI results:
< 0.9 abnormal
0.9-1 borderline
1-1.4 normal
> 1.4 non-compressible
400
Homan's sign definition
What is pain upon simultaneous foot dorsiflexion and calf squeeze (with knee elevated/extended)?
500
Priority diagnostic test for patient with severe cellulitis
What is XR of affected extremity?
500
Identify any abnormality in the arterial ultrasound report.
What is arterial insufficiency in the left leg?
500
Cause of brown skin discoloration in PVD
What is hemosiderin deposition?