Peripheral artery disease: The Daily PANCE Blueprint

The answer is C. <0.90

Peripheral arterial disease is defined by atherosclerotic occlusion of the peripheral arteries, most commonly in the lower extremities. Symptoms include intermittent claudication, atypical leg pain, and non-healing ulcers. On physical exam you may see hair loss, pallor with leg elevation, dry skin, and ulcers (typically lateral malleolus). Risk factors include smoking, diabetes, obesity, hypertension, hyperlipidemia, and kidney disease. Diagnosis can made by a resting ankle-brachial index (ABI) of <0.90. Definitive diagnosis is contrast arteriography. The pathophysiology is as follows: arterial narrowing from atherosclerosis leads to inadequate O2 delivery to the muscle during increased demand, causing claudication. Management includes smoking cessation, blood pressure control, high-intensity statin, supervised exercise therapy, and antiplatelet therapy with aspirin or clopidogrel (preferred) when there are no contraindications.