[MCQ] Vascular Diseases of the Extremities

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Vascular Diseases of the Extremities

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Question 1

In patients with peripheral arterial disease, the ankle:brachial index (ABI) is ?

A	< 0.4
B	< 0.6
C	< 0.8
D	< 1

Question 1 Explanation:

In hemodynamically significant arterial stenoses, systolic blood pressure in leg is decreased. Ratio of ankle and brachial artery pressures (ankle:brachial index or ABI) is >=1.0 in normal individuals and <1.0 in patients with peripheral arterial disease; a ratio of <0.5 is consistent with severe ischemia

Question 2

“String of beads” appearance on angiography is characteristic of ?

A	Fibromuscular dysplasia
B	Thromboangiitis obliterans
C	Takayasu’s arteritis
D	Giant cell (temporal) arteritis

Question 2 Explanation:

String of beads” appearance on angiography is characteristic of fibromuscular dysplasia caused by thickened fibromuscular ridges contiguous with thin, less-involved portions of the arterial wall.

Question 3

Clinical features of thromboangiitis obliterans include ?

A	Claudication of affected extremity
B	Raynaud’s phenomenon
C	Migratory superficial vein thrombophlebitis
D	All of the above

Question 3 Explanation:

Clinical features of thromboangiitis obliterans include a triad of claudication of the affected extremity, Raynaud’s phenomenon, and migratory superficial vein thrombophlebitis

Question 4

In lower extremities, emboli lodge most frequently in ?

A	Femoral artery
B	Iliac artery
C	Popliteal artery
D	Popliteal artery

Question 4 Explanation:

n lower extremities, emboli lodge most frequently in femoral artery, followed by iliac artery, aorta, and popliteal and tibioperoneal arteries

Question 5

“Blue toe” syndrome is best related to ?

A	Frostbite
B	Raynaud’s phenomenon
C	Atheroembolism
D	Arteriovenous Fistula

Question 5 Explanation:

Atheroembolism causes cyanotic discoloration & impending necrosis of the toes termed as “blue toe syndrome”.

Question 6

Paget-Schroetter syndrome is best related to ?

A	Frostbite
B	Thoracic Outlet Compression Syndrome
C	Thoracic Outlet Compression Syndrome
D	Arteriovenous Fistula

Question 6 Explanation:

Thoracic outlet compression syndrome may be divided into arterial, venous & neurogenic forms. Patients with neurogenic thoracic outlet compression may develop shoulder & arm pain, weakness, & paresthesias. Patients with arterial compression experience claudication, Raynaud’s phenomenon, ischemic tissue loss & gangrene. Venous compression causes thrombosis of subclavian & axillary veins, often associated with effort & is referred to as Paget-Schroetter syndrome

Question 7

Which of the following maneuvers is useful in diagnosis of thoracic outlet compression syndrome ?

A	Hyperabduction maneuver
B	Scalene maneuver
C	Costoclavicular maneuver
D	All of the above

Question 7 Explanation:

Maneuvers used for diagnosis of thoracic outlet compression syndrome include abduction & external rotation test, in which affected arm is abducted by 90° & shoulder is externally rotated. Scalene maneuver (extension of neck & rotation of head to side of symptoms). Costoclavicular maneuver (posterior rotation of shoulders) & hyperabduction maneuver (raising arm to 180°

Question 8

Nicoladoni-Branham sign refers to ?

A	Tenderness in supraclavicular fossa
B	Compression of large arteriovenous fistula causing reflex slowing of heart rate
C	Hyperabduction maneuver causing subclavian bruits
D	Hyperabduction maneuver causing loss of pulses in arm

Question 8 Explanation:

Compression of a large arteriovenous fistula may cause reflex slowing of the heart rate. This is called Nicoladoni-Branham sign.

Question 9

On cold exposure, which of the following is the first to occur in Raynaud’s phenomenon ?

A	Pallor
B	Cyanosis
C	Rubor
D	None of the above

Question 9 Explanation:

Raynaud’s phenomenon is characterized by episodic digital ischemia, manifested clinically by sequential development of digital blanching or pallor, cyanosis, & rubor of fingers or toes following cold exposure & subsequent rewarming.

Question 10

In Raynaud’s phenomenon, patients experience throbbing pain during which phase ?

A	Pallor
B	Cyanosis
C	Rubor
D	None of the above

Question 10 Explanation:

Blanching or pallor represents the ischemic phase of Raynaud’s phenomenon and results from vasospasm of digital arteries. During ischemic phase, capillaries & venules dilate and cyanosis results from deoxygenated blood that is present in these vessels. A sensation of cold or numbness or paresthesia of the digits often accompanies the phases of pallor and cyanosis. With rewarming, the digital vasospasm resolves, and blood flow into the dilated arterioles and capillaries increases dramatically. This “reactive hyperemia” imparts a bright red color to the digits. In addition to rubor and warmth, patients often experience a throbbing, painful sensation during the hyperemic phase

Question 11

Which of the following about Raynaud’s disease is false ?

A	50% with Raynaud’s phenomenon have Raynaud’s disease
B	Women are affected 5 times more than men
C	Age of presentation is between 20 and 40 years
D	Toes are involved more frequently than fingers

Question 11 Explanation:

Over 50% of patients with Raynaud’s phenomenon have Raynaud’s disease. Women are affected about five times more often than men, and the age of presentation is usually between 20 and 40 years. Fingers are involved more frequently than the toes.

Question 12

Which of the following about Raynaud’s phenomenon is false ?

A	Occurs frequently in patients who also have migraine
B	Occurs frequently in patients who also have variant angina
C	Radial, ulnar and pedal pulses are abnormal
D	Fingers and toes perspire excessively between attacks

Question 12 Explanation:

Raynaud’s phenomenon occurs frequently in patients who also have migraine headaches or variant angina. Radial, ulnar, and pedal pulses are normal. The fingers and toes may be cool between attacks and may perspire excessively

Question 13

Which of the following drugs does not cause Raynaud’s phenomenon ?

A	Methysergide
B	α-adrenergic receptor antagonists
C	β-adrenergic receptor antagonists
D	None of the above

Question 14

Which of the following drugs cause Raynaud’s phenomenon ?

A	Bleomycin
B	Vinblastine
C	Cisplatin
D	All of the above

Question 14 Explanation:

Drugs that can cause Raynaud’s phenomenon include ergot derivatives, methysergide, betaadrenergic receptor blockers, bleomycin, vinblastine and cisplatin.

Question 15

Which of the following diseases can present as Raynaud’s phenomenon ?

A	Scleroderma
B	Systemic lupus erythematosus
C	Dermatomyositis or polymyositis
D	All of the above

Question 15 Explanation:

Raynaud’s phenomenon occurs in patients with systemic sclerosis (scleroderma), systemic lupus erythematosus (SLE), dermatomyositis or polymyositis, rheumatoid arthritis, atherosclerosis of extremities, thromboangiitis obliterans, acute occlusion of large and mediumsized arteries by a thrombus or embolus, thoracic outlet compression syndrome, primary pulmonary hypertension, blood dyscrasias, use of vibrating hand tools, pianists and keyboard operators. Electric shock injury to the hands or frostbite may lead to the later development of Raynaud’s phenomenon.

Question 16

Which of the following drug is useful in Raynaud’s phenomenon ?

A	Nifedipine
B	Prazosin
C	Methyldopa
D	Methyldopa

Question 17

Which of the following drug is useful in Raynaud’s phenomenon ?

A	Amlodipine
B	Terazosin
C	Phenoxybenzamine
D	All of the above

Question 17 Explanation:

Dihydropyridine calcium channel antagonists (nifedipine, isradipine, felodipine & amlodipine) are useful. Postsynaptic alpha 1-adrenergic antagonist prazosin, doxazosin & terazosin may be effective. Sympatholytic agents methyldopa, guanethidine & phenoxybenzamine may be useful. Digital sympathectomy is helpful in those who are unresponsive to medical therapy

Question 18

Which of the following is false about acrocyanosis ?

A	Persistent cyanosis of the hands
B	Normal pulses
C	Trophic skin changes and ulcerations do not occur
D	None of the above

Question 18 Explanation:

In acrocyanosis, there is arterial vasoconstriction & secondary dilation of capillaries & venules with resulting persistent cyanosis of hands & feet. Pain, ulcers & gangrene do not occur. Pulses are normal & blanching does not occur.

Question 19

Secondary acrocyanosis is associated with ?

A	Brain tumour
B	Lung cancer
C	Infective hepatitis
D	Infective hepatitis

Question 19 Explanation:

Secondary acrocyanosis may result from hypoxemia, connective tissue diseases, atheroembolism, antiphospholipid antibodies, cold agglutinins, or cryoglobulins, and is associated with anorexia nervosa and orthostatic tachycardia syndrome.

Question 20

“Atrophie blanche en plaque” is the term given to ?

A	Myxoedema dermopathy
B	Thyroid acropachy
C	Primary livedo reticularis with ulceration
D	Secondary livedo reticularis

Question 20 Explanation:

Primary livedo reticularis with ulceration is called atrophie blanche en plaque

Question 21

Secondary livedo reticularis can occur with ?

A	Atheroembolism
B	SLE
C	Anticardiolipin antibodies
D	All of the above

Question 21 Explanation:

Secondary livedo reticularis can occur with atheroembolism, SLE, anticardiolipin antibodies, hyperviscosity, cryoglobulinemia & Sneddon’s syndrome (ischemic stroke & livedo reticularis)

Question 22

The other name of ‘Pernio’ is ?

A	Acrocyanosis
B	Erythromelalgia
C	Chilblains
D	Frostbite

Question 23

Which of the following best relates to Pernio (Chilblains) ?

A	Atheroembolism
B	Mechanical trauma
C	Vasculitic disorder
D	All of the above

Question 23 Explanation:

Pernio (Chilblains) is a vasculitic disorder associated with exposure to cold. Raised erythematous lesions develop on lower part of legs & feet in cold weather. These are associated with pruritus and a burning sensation, and they may blister and ulcerate.

Question 24

Which of the following is false about erythromelalgia ?

A	Characterized by burning pain and erythema of extremities
B	Feet involved more frequently than hands
C	Males affected more frequently than females
D	None of the above

Question 24 Explanation:

Erythromelalgia is characterized by burning pain and erythema of the extremities. The feet are involved more frequently than hands, and males are affected more frequently than females

Question 25

Which of the following is false about erythromelalgia ?

A	May be secondary to myeloproliferative disorders
B	May occur as an adverse effect of nifedipine
C	May occur as an adverse effect of bromocriptine
D	Burning sensation is precipitated by exposure to cold environment

Question 25 Explanation:

Secondary erythromelalgia occurs with myeloproliferative disorders such as polycythemia vera and essential thrombocytosis. Less-common causes include drugs, such as calcium channel blockers, bromocriptine, and pergolide; neuropathies; connective tissue diseases, such as SLE and paraneoplastic syndromes. Patients complain of burning in the extremities that is precipitated by exposure to a warm environment and aggravated by a dependent position. The symptoms are relieved by exposing the affected area to cool air or water or by elevation

Question 26

Venulitis is a feature of ?

A	Thromboangiitis obliterans
B	Behçet’s syndrome
C	Homocystinuria
D	All of the above

Question 26 Explanation:

Venulitis occurring in thromboangiitis obliterans, Behçet’s syndrome and homocystinuria may cause venous thrombosis.

Question 27

Phlegmasia cerulea dolens’ refers to ?

A	Deoxygenated hemoglobin in stagnant veins giving cyanotic hue to limb
B	Pain on antigravity movement of DVT affected limb
C	DVT affected veins that are likely to embolize
D	Chronic venous insufficiency

Question 28

‘Phlegmasia alba dolens’ refers to ?

A	Deoxygenated hemoglobin in stagnant veins giving cyanotic hue to limb
B	Pain on antigravity movement of DVT affected limb
C	DVT affected veins that are likely to embolize
D	Pallor in markedly edematous DVT affected legs

Question 29

‘Phlegmasia alba dolens’ refers to ?

A	Deoxygenated hemoglobin in stagnant veins giving cyanotic hue to limb
B	Pain on antigravity movement of DVT affected limb
C	DVT affected veins that are likely to embolize
D	Pallor in markedly edematous DVT affected legs

Question 30

Primary lymphedema may be associated with ?

A	Turner syndrome
B	Klinefelter syndrome
C	Noonan syndrome
D	All of the abov

Question 31

Primary lymphedema may be associated with ?

A	Yellow nail syndrome
B	Intestinal lymphangiectasia syndrome
C	Lymphangiomyomatosis
D	All of the above

Question 32

Lymphedema tarda usually begins after the age of ?

A	1 year
B	14 years
C	25 years
D	35 years

Question 32 Explanation:

Congenital lymphedema appears shortly after birth, lymphedema praecox has its onset at the time of puberty and lymphedema tarda usually begins after age 35

Question 33

Milroy’s disease is best described as ?

A	Congenital lymphedema
B	Lymphedema praecox
C	Lymphedema tarda
D	Bacterial lymphangitis

Question 33 Explanation:

Familial forms of congenital lymphedema (Milroy’s disease) and lymphedema praecox (Meige’s disease) may be inherited in an autosomal dominant manner with variable penetrance.

Question 34

Most common cause of secondary lymphedema worldwide is ?

A	Bacterial lymphangitis
B	Filariasis
C	Radiation therapy for breast carcinoma
D	Pregnancy

Question 34 Explanation:

Most common cause of secondary lymphedema worldwide is filariasis.

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See all quizzes of Vascular Diseases of the Extremities at here:

1.In patients with peripheral arterial disease, the ankle:brachial index (ABI) is ?
A. < 0.4
B. < 0.6
C. < 0.8
D. < 1

2. “String of beads” appearance on angiography is characteristic of ?
A. Fibromuscular dysplasia
B. Thromboangiitis obliterans
C. Takayasu’s arteritis
D. Giant cell (temporal) arteritis

3. Clinical features of thromboangiitis obliterans include ?
A. Claudication of affected extremity
B. Raynaud’s phenomenon
C. Migratory superficial vein thrombophlebitis
D. All of the above

4. In lower extremities, emboli lodge most frequently in ?
A. Femoral artery

B. Iliac artery
C. Popliteal artery
D. Tibioperoneal arteries

5. “Blue toe” syndrome is best related to ?
A. Frostbite
B. Raynaud’s phenomenon
C. Atheroembolism
D. Arteriovenous Fistula

6. Paget-Schroetter syndrome is best related to ?
A. Frostbite
B. Thoracic Outlet Compression Syndrome
C. Atheroembolism
D. Arteriovenous Fistula

7. Which of the following maneuvers is useful in diagnosis of thoracic outlet compression syndrome ?
A. Hyperabduction maneuver
B. Scalene maneuver
C. Costoclavicular maneuver
D. All of the above

8. Nicoladoni-Branham sign refers to ?
A. Tenderness in supraclavicular fossa
B. Compression of large arteriovenous fistula causing reflex
slowing of heart rate
C. Hyperabduction maneuver causing subclavian bruits
D. Hyperabduction maneuver causing loss of pulses in arm

9. On cold exposure, which of the following is the first to occur in Raynaud’s phenomenon ?
A. Pallor
B. Cyanosis
C. Rubor
D. None of the above

10. In Raynaud’s phenomenon, patients experience throbbing pain during which phase ?
A. Pallor
B. Cyanosis
C. Rubor
D. None of the above

11. Which of the following about Raynaud’s disease is false ?
A. 50% with Raynaud’s phenomenon have Raynaud’s disease
B. Women are affected 5 times more than men
C. Age of presentation is between 20 and 40 years
D. Toes are involved more frequently than fingers

12. Which of the following about Raynaud’s phenomenon is false ?
A. Occurs frequently in patients who also have migraine
B. Occurs frequently in patients who also have variant angina
C. Radial, ulnar and pedal pulses are abnormal
D. Fingers and toes perspire excessively between attacks

13. Which of the following drugs does not cause Raynaud’s phenomenon ?
A. Methysergide
B. -adrenergic receptor antagonists
C. -adrenergic receptor antagonists
D. None of the above
14. Which of the following drugs cause Raynaud’s phenomenon ?
A. Bleomycin
B. Vinblastine
C. Cisplatin
D. All of the above

15. Which of the following diseases can present as Raynaud’s phenomenon ?
A. Scleroderma
B. Systemic lupus erythematosus
C. Dermatomyositis or polymyositis

D. All of the above

16. Which of the following drug is useful in Raynaud’s phenomenon ?
A. Nifedipine
B. Prazosin
C. Methyldopa
D. All of the above
17. Which of the following drug is useful in Raynaud’s phenomenon ?
A. Amlodipine
B. Terazosin
C. Phenoxybenzamine
D. All of the above

18. Which of the following is false about acrocyanosis ?
A. Persistent cyanosis of the hands
B. Normal pulses
C. Trophic skin changes and ulcerations do not occur
D. None of the above
.
19. Secondary acrocyanosis is associated with ?
A. Brain tumour
B. Lung cancer
C. Infective hepatitis
D. Anorexia nervosa

20. “Atrophie blanche en plaque” is the term given to ?3
A. Myxoedema dermopathy
B. Thyroid acropachy
C. Primary livedo reticularis with ulceration
D. Secondary livedo reticularis
.
21. Secondary livedo reticularis can occur with ?
A. Atheroembolism
B. SLE

C. Anticardiolipin antibodies
D. All of the above
.
22. The other name of ‘Pernio’ is ?
A. Acrocyanosis
B. Erythromelalgia
C. Chilblains
D. Frostbite
23. Which of the following best relates to Pernio (Chilblains) ?
A. Atheroembolism
B. Mechanical trauma
C. Vasculitic disorder
D. All of the above

24. Which of the following is false about erythromelalgia ?
A. Characterized by burning pain and erythema of extremities
B. Feet involved more frequently than hands
C. Males affected more frequently than females
D. None of the above

25. Which of the following is false about erythromelalgia ?
A. May be secondary to myeloproliferative disorders
B. May occur as an adverse effect of nifedipine
C. May occur as an adverse effect of bromocriptine
D. Burning sensation is precipitated by exposure to cold
environment

26. Venulitis is a feature of ?
A. Thromboangiitis obliterans
B. Behçet’s syndrome
C. Homocystinuria
D. All of the above

27. ‘Phlegmasia cerulea dolens’ refers to ?
A. Deoxygenated hemoglobin in stagnant veins giving
cyanotic hue to limb

B. Pain on antigravity movement of DVT affected limb
C. DVT affected veins that are likely to embolize
D. Chronic venous insufficiency
28. ‘Phlegmasia alba dolens’ refers to ?
A. Deoxygenated hemoglobin in stagnant veins giving cyanotic hue to limb
B. Pain on antigravity movement of DVT affected limb
C. DVT affected veins that are likely to embolize
D. Pallor in markedly edematous DVT affected legs
29. Primary lymphedema may be associated with ?
A. Turner syndrome
B. Klinefelter syndrome
C. Noonan syndrome
D. All of the above
30. Primary lymphedema may be associated with ?
A. Yellow nail syndrome
B. Intestinal lymphangiectasia syndrome
C. Lymphangiomyomatosis
D. All of the above

31. Lymphedema tarda usually begins after the age of ?
A. 1 year
B. 14 years
C. 25 years
D. 35 years

32. Milroy’s disease is best described as ?
A. Congenital lymphedema
B. Lymphedema praecox
C. Lymphedema tarda
D. Bacterial lymphangitis

33. Most common cause of secondary lymphedema worldwide is ?
A. Bacterial lymphangitis
B. Filariasis
C. Radiation therapy for breast carcinoma
D. Pregnancy

Vascular Diseases of the Extremities

[MCQ] Vascular Diseases of the Extremities

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Vascular Diseases of the Extremities

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