PAD initial step

[StudentDoctorM]

I am studying for the COMLEX CE and constantly struggle with the initial vs next vs best exams.
For example, someone who presents with classic Peripheral arterial disease, what is the initial step?

I would think it is to get the ABI.. but if it is classic symptoms, do we need it or do we go straight to treatment?
and in terms of treatment, does it depend on patient presentation? if unstable = go straight to surgery, if stable = give anticoagulation/tPA, statins?

So, to answer these questions it is a case by case thing, right? ie. depends if it is an unstable/stable patient, classic/non-classic presentation, etc. Or is there a guideline for every single person that presents with PAD?

Sorry, I know this post is a lot of different questions at once and I hope it made sense. If someone can help me figure it out, I would be forever grateful.

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[Instatewaiter]

I am studying for the COMLEX CE and constantly struggle with the initial vs next vs best exams.
For example, someone who presents with classic Peripheral arterial disease, what is the initial step?

I would think it is to get the ABI.. but if it is classic symptoms, do we need it or do we go straight to treatment?
and in terms of treatment, does it depend on patient presentation? if unstable = go straight to surgery, if stable = give anticoagulation/tPA, statins?

So, to answer these questions it is a case by case thing, right? ie. depends if it is an unstable/stable patient, classic/non-classic presentation, etc. Or is there a guideline for every single person that presents with PAD?

Sorry, I know this post is a lot of different questions at once and I hope it made sense. If someone can help me figure it out, I would be forever grateful.

For all of the USMLEs the trajectory in every question is going to be:
1) Obtain history/exam
2) Confirm the diagnosis with testing
3) Treat

So if you haven't confirmed the diagnosis, you probably shouldn't be treating. So even with classic claudications you should be getting ABIs and PVRs to confirm there is PAD and help with determining the level of the obstruction. Even if there is critical limb ischemia, the first step is going to be confirming the diagnosis with testing (either emergent peripheral cath with intervention or CTA with runoff).