A 70-Year-Old Woman with Atrial Fibrillation and a Cold, Pale, Painful Leg
A branching clinical case simulation for a patient presenting with suddenly cold, painful, pale left leg. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min6 stages
- Patient
- 70 years, female
- Presenting complaint
- Suddenly cold, painful, pale left leg
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are a Year 4 medical student working in the emergency department of a district general hospital. Mrs Margaret Whitfield, a 70-year-old woman, has just arrived via ambulance with a 2-hour history of sudden, severe pain in her left leg. She is anxious and in distress. Her leg is pale and cold. You are the first clinician to assess her. Remember to approach this systematically and think about time-critical management.
What this case teaches
Recognise the six Ps of acute limb ischaemia; start heparin promptly; make an urgent vascular referral; understand the time-critical nature of revascularisation.
How the case unfolds
- 1Take a focused historyHistory
- 2Examine the left legExamination
- 3Order investigationsInvestigations
- 4Make the diagnosisDiagnosis
- 5Immediate managementTreatment
- 6Monitoring and ongoing careMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.