what's this?

[match2011]

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A previously healthy 37y F comes to the physician because of leg pain for 2 days. Medications include an oral contraceptive and calcium supplementation. Ex: distal left lower extremity shows a subcutaneous, palpable, hard, cord-like structure with a 6x1 cm, warm, erythematous area just proximal to the ankle. There are scattered varicose veins in the lower extremities. what‘s this？

 

[Psychotropic]

A previously healthy 37y F comes to the physician because of leg pain for 2 days. Medications include an oral contraceptive and calcium supplementation. Ex: distal left lower extremity shows a subcutaneous, palpable, hard, cord-like structure with a 6x1 cm, warm, erythematous area just proximal to the ankle. There are scattered varicose veins in the lower extremities. Which of the following is the most appropriate next step in management?

A. application of warm compresses
B. use of compression stocking
C. oral dicloxacillin
D. oral prednisone therapy
E. subcutaneous enoxaparin therapy

I'm not the brightest person in the world, but it sounds like a DVT. The physical exam description (palpable cord, really?) and the fact that she's taking an OCP kind of gives it away.

The only answer that would make sense to me would be anticoagulation (E).

Is this supposed to be a trick question or something, because it looks pretty straight forward to me.

 

[Valadi]

A previously healthy 37y F comes to the physician because of leg pain for 2 days. Medications include an oral contraceptive and calcium supplementation. Ex: distal left lower extremity shows a subcutaneous, palpable, hard, cord-like structure with a 6x1 cm, warm, erythematous area just proximal to the ankle. There are scattered varicose veins in the lower extremities. Which of the following is the most appropriate next step in management?

A. application of warm compresses
B. use of compression stocking
C. oral dicloxacillin
D. oral prednisone therapy
E. subcutaneous enoxaparin therapy

Sounds like superficial thrombophlebitis to me, not a DVT, infection, pyoderma gangrenosum (which often occurs in the distal leg, hence the steroid option), or plain varicosity related or varicose-ulcer. Treatment for superficial thrombophlebitis is warm compress + NSAIDs. "Superficial palpable cord" is kind are kind of the buzz words for it.

 

[chui684]

this is an nbme4 q which shouldn't really be discussed here... it's E btw.