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Acute limb ischaemia from embolus — SCE Acute Medicine MCQ

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EasyAcute Cardiac PresentationsAcute limb ischaemia from embolusSCE Acute Medicine

A 77-year-old man is assessed on the acute medical unit. He has atrial fibrillation and sudden painful pale left leg. The foot is cool with absent Doppler signals but motor function is preserved. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: D — Give intravenous unfractionated heparin and urgent vascular referral

Give intravenous unfractionated heparin and urgent vascular referral is the best answer because acute limb ischaemia needs immediate anticoagulation and vascular assessment to preserve limb viability. Refer for urgent endoscopy after resuscitation is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: The six Ps help grade severity and urgency.

Reference: NICE CKS peripheral arterial disease