Embolic Showers

B.P. is a 63-year-old uninsured female (self-pay) who presents as a walk-in after referral from a retail clinic for worsening acute left foot pain described as a cramp-like spasm over the distal dorsal and plantar foot. She denies injury, new shoes, increased activity, or skin changes, and has had no relief with acetaminophen or topical lotions; she also notes mild early discomfort in the right toes. She has no PCP and minimal recent medical care. After initially denying history, she reports type 2 diabetes (stopped metformin), a prior “heart attack” (stopped clopidogrel), and hypertension (never took prescribed medication).