Venous insufficiency: The Daily PANCE Blueprint

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Venous insufficiency: The Daily PANCE Blueprint

A 62-year-old female with a history of prior DVT, HTN, HLD, and tobacco abuse presents with chronic leg discomfort and swelling that worsens after standing for long periods. Physical exam reveals varicose veins and hyperpigmentation around the medial ankle Which of the following is the most appropriate initial diagnostic test to evaluate this patient’s condition?

A. Ankle-brachial index
B. CT venography
C. Venous duplex ultrasonography
D. D-dimer assay
E. CT arteriography

Answer and topic summary

The answer is C. Venous duplex ultrasonography

Chronic venous insufficiency is defined by disturbances in the venous outflow. Risk factors include advancing age, family history, prolonged standing, smoking, sedentary lifestyle, lower extremity trauma, prior deep venous thrombosis, and pregnancy. Clinical features vary but can include: spider veins, heavy/discomfort in legs, varicose veins, leg edema, pigmentation, atrophie blanche, and venous ulceration. Venous duplex ultrasonography is the most common diagnostic tool. Management initially includes compression stockings and risk modifications (i.e., exercise, stop smoking, etc).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology ⇒ Vascular Disease (PEARLS) ⇒ Venous insufficiency (ReelDx)

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