Chapter 12: The Peripheral Vascular System ; Bates’ Guide to Physical Examination and History Taking, 12th Edition

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Bates’ Guide to Physical Examination and History Taking, 11th Edition Chapter 12: The Peripheral Vascular System Multiple Choice 1. A 57-year-old maintenance worker comes to your office for evalu ... ation of pain in his legs. He has smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system? A) Intermittent claudication B) Chest pressure with exertion C) Shortness of breath D) Knee pain Ans: A Chapter: 12 Page and Header: 477, The Health History Feedback: Intermittent claudication is leg pain that occurs with walking and is relieved by rest. It is a key symptom of peripheral vascular disease. This symptom is present in only about one third of patients with significant arterial disease and, if found, calls for more aggressive management of cardiovascular risk factors. Screening with ankle brachial index can help detect this problem. 2. A 72-year-old teacher comes to your clinic for an annual examination. She is concerned about her risk for peripheral vascular disease and states that there is a place in town that does tests to let her know her if she has this or not. Which of the following disease processes is a risk factor for peripheral vascular disease? A) Gastroesophageal reflux disease B) Coronary artery disease C) Migraine headaches D) Osteoarthritis Ans: B Chapter: 12 Page and Header: 478, Health Promotion and Counseling This study source was downloaded by 100000831988016 from CourseHero.com on 05-06-2022 10:47:40 GMT -05:00 https://www.coursehero.com/file/18397505/Chapter-12-The-Peripheral-Vascular-System/ Feedback: Evidence of coronary artery disease implies that there is most likely disease in other vessels; therefore, this is a risk factor for peripheral vascular disease. Conversely, the presence of peripheral vascular disease is also a risk factor for coronary artery disease, and if present, it should be considered in reduction of cardiac risk factors. 3. A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease. Which of the following tests are appropriate to order to initially evaluate for this condition? A) Venogram B) CT scan of the lower legs C) Ankle–brachial index (ABI) D) PET scan Ans: C Chapter: 12 Page and Header: 478, Health Promotion and Counseling Feedback: The ankle–brachial index is a good test for obtaining information about significant stenosis in the vessels of the lower extremities. Sixteen percent of patients with known peripheral vascular disease also have coronary artery disease. 4. A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms? A) Femoral pulse, popliteal pulse B) Dorsalis pedis pulse, posterior tibial pulse C) Carotid pulse D) Radial pulse, brachial pulse Ans: D Chapter: 12 Page and Header: 481, Techniques of Examination Feedback: This is an important aspect of physical examination to assess for peripheral vascular disease. This patient is at risk for disease in this distribution because of her recent radiation therapy. This study source was downloaded by 100000831988016 from CourseHero.com on 05-06-2022 10:47:40 GMT -05:00 https://www.coursehero.com/file/18397505/Chapter-12-The-Peripheral-Vascular-System/ 5. You are a student in the vascular surgery clinic. You are asked to perform a physical examination on a patient with known peripheral vascular disease in the legs. Which of the following aspects is important to note when you perform your examination? A) Size, symmetry, and skin color B) Muscle bulk and tone C) Nodules in joints D) Lower extremity strength Ans: A Chapter: 12 Page and Header: 481, Techniques of Examination Feedback: This is an important aspect to note in physical examination. Swelling in the legs, cyanosis, and lack of appropriate hair growth are all signs of peripheral vascular disease. 6. You are assessing a patient for peripheral vascular disease in the arms, secondary to a complaint of increased weakness and a history of coronary artery disease and diabetes. You assess the brachial and radial pulses and note that they are bounding. What does that translate to on a scale of 0 to 3? A) 0 B) 3+ C) 2+ D) 1+ Ans: B Chapter: 12 Page and Header: 481, Techniques of Examination Feedback: A pulse of 3+ is considered to be bounding. 7. You are obtaining an arterial blood gas in the radial artery on a retired cab driver who has been hospitalized in the intensive care unit for a stroke. You are concerned about the possibility of arterial insufficiency. You perform the Allen test. This means that you: A) Checked for patency of the radial artery B) Checked for patency of the brachial artery C) Checked for patency of the ulnar artery D) Checked for patency of the femoral artery Ans: C Chapter: 12 Page and Header: 488, Special Techniques Feedback: The Allen test is for determining patency of the ulnar artery before puncturing the This study source was downloaded by 100000831988016 from CourseHero.com on 05-06-2022 10:47:40 GMT -05:00 https://www.coursehero.com/file/18397505/Chapter-12-The-Peripheral-Vascular-System/ radial artery. In the event of an occlusion in the radial artery system, the ulnar artery can provide adequate blood flow. 8. You are assessing a 59-year-old gas station owner for atherosclerosis in the lower extremities. In which of the following locations would the patient's pain make you concerned for this disease process? A) Thigh B) Knee C) Calf D) Ankle Ans: C Chapter: 12 Page and Header: 477, The Health History Feedback: Pain in the calf is the most common site for claudication; however, there could be pain in the buttock, hip, thigh, or foot, depending on the level of the obstruction. The absence of this pain does not rule out significant vascular disease, and actually the minority of these patients are symptomatic. 9. You are performing a routine check-up on an 81-year-old retired cotton farmer in the vascular surgery clinic. You note that he has a history of chronic arterial insufficiency. Which of the following physical examination findings in the [Show More]

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