Chapter 12: The Peripheral Vascular System
Multiple Choice
1. A 57-year-old maintenance worker comes to your office for evaluation 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
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common or concerning symptoms for the peripheral vascular system?
A) Intermittent claudication
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B) Chest pressure with exertion
C) Shortness of breath
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D) Knee pain
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Ans: A
Chapter: 12
Page and Header: 477, The Health History
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Feedback: Intermittent claudication is leg pain that occurs with walking and is relieved by rest.
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It is a key symptom of peripheral vascular disease. This symptom is present in only about one
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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.
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2. A 72-year-old teacher comes to your clinic for an annual examination. She is concerned about
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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
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for peripheral vascular disease?
A) Gastroesophageal reflux disease
B) Coronary artery disease
C) Migraine headaches
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D) Osteoarthritis
Ans: B
Chapter: 12
Page and Header: 478, Health Promotion and Counseling
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, 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
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Ans: C
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Chapter: 12
Page and Header: 478, Health Promotion and Counseling
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Feedback: The ankle–brachial index is a good test for obtaining information about significant
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stenosis in the vessels of the lower extremities. Sixteen percent of patients with known
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peripheral vascular disease also have coronary artery disease.
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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?
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A) Femoral pulse, popliteal pulse
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B) Dorsalis pedis pulse, posterior tibial pulse
C) Carotid pulse
D) Radial pulse, brachial pulse
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Ans: D
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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
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therapy.
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