Question of the Week # 413

413)  A 60-year-old woman with history of stage III melanoma of the right lower extremity underwent a lymph node dissection about one year ago. Now, she presents with pain in her right lower extremity that started about one week ago and is progressively worse. Over the last two days, she developed bluish discoloration of the right great toe . On examination, her vitals are stable. There is gross swelling of the entire right lower extremity with bluish discoloration of right great toe and extreme tenderness . Dorsalis and posterior tibial artery pulses are slightly diminished. Which of the following is the most likely diagnosis?

A) Chronic Venous Insufficiency

B) Phlegmasia Alba Dolens

C) Phlegmasia Cerulea Dolens

D) Lymphedema

D) Peripheral Arterial Disease

6 Responses

  1. A

  2. D.

  3. C

  4. C) Phlegmasia Cerulea Dolens

  5. c) Phlegmasia Cerulea Dolens
    It is a severe form of deep vein thrombosis. It results from extensive thrombotic occlusion of major and collateral veins of extremities.
    It presents with sudden onset of sever pain, swelling, cyanosis, sometimes foot gangrene.

  6. ~C

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