Get Answer: Year Presents Emergency Question Guide

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Original Question

A 59-year-old man presents to the emergency department because of acute severe right leg pain that started an hour ago and has some associated numbness. He is accompanied by his wife, who says he has a heart rhythm problem for which he takes a blood thinner, but he is not adherent to taking his medication. He has smoked 10-15 cigarettes daily for the past 15 years. His temperature is 36.9.C (98.4.F), blood pressure is 140/90_mm Hg, and heart rate is 85/min with an irregular pulse. On physical examination, the patient is anxious, and his right leg is cool and pale. Capillary refill is delayed. The right popliteal and pedal pulses are absent. He has no motor deficits and minimally decreased sensation in the toes. There are audible venous doppler but no arterial doppler signals. What is the best initial step in managing this patient’s condition? A. Cilostazol B. Decompressive laminectomy C. Immediate surgical revascularization O D. Oral acetaminophen and topical capsaicin E. Amputation

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