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NBME 23 Answers

nbme23/Block 2/Question#37 (reveal difficulty score)
A 62-year-old woman is brought to the ...
Embolus to the femoral artery with left leg ischemia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +8  upvote downvote
submitted by โˆ—paulkarr(73)
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I had a pretty straight forward line of thinking for this. Cool discolored leg automatically rules out problems elsewhere (all the brain related choices). We know blood has been cut off to the left foot. Specifically, there is an embolus in the arterial blood supply. (Venous would lead to a warm foot)

If you take into account the acute episodes of palpitations, it is plausible to think that she had some sort of A-Fib triggering a blood clot to break off and be sent through the systemic circulation. It then got lodged in the femoral artery cutting off poor g-ma's blood.

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an1  how would it appear if it were brain related? just a total loss of motor? or are there any visual signs. and why is arterial discoloured? +



 +5  upvote downvote
submitted by โˆ—imnotarobotbut(184)
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Cool, discolored foot with tingling and numbness = blood clot. Cardiac symptoms may indicate that she has some sort of thrombotic disease. The wording of the answer choice isn't great, but none of the other answer choices fit.

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