doc_clotaire
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A 39-year-old Polish man comes to the clinic for painful calves after
walking long distances and for discoloration of the fingers with
changes in temperature. He says his symptoms started two months ago,
and he gets no relief from the ibuprofen. He has previously been
healthy. He currently smokes a pack a day and drinks socially. He has
no history of drug abuse. On physical examination, his blood pressure
is 140/90 mm Hg, heart rate is 68/min, and he is afebrile. Examination
of the hands reveals distal digital ischemia and trophic changes in
the nails of both hands. Radial pulses are absent bilaterally, but all
other pulses are present. His right calf shows evidence of a
superficial thrombophlebitis. Laboratory studies show: white cell
count 9,600/mm3, hematocrit 38.6%, MCV 89 μm3, ESR 40 mm/h, and
C-ANCA as negative. The rheumatoid factor and ANA are negative. Which
of the following should be done next for this patient?
(A) Heparin
(B) Prednisone
(C) Arterial bypass
(D) Cyclophosphamide
(E) Abstention from tobacco
DIAGNOSIS AND EXPLANATION PLEASE !
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| Aashi
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This is Buerger's disease( thromboangiitis obliterans)-triad of a young pt+ smoker + claudication--> no specific med t/t--Abstaining from SMOKING is the best t/t--->if continued to smoke-->prognosis not good------- SO I go for A( typo)--->meant E
GL
Edited by Aashi on 02/07/07 - 09:30 PM
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| webjeee
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so, why not E
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| neuroblastoma
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E
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| robin082006
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E
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| DrVirgo
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Yup, Thromboangitis Obliterans aka Buerger's Disease.... NO Steroids, the only tr. is to QUIT SMOKING... E.
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| doc_clotaire
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Right guys !
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The elevator to succes is broke ,you must take the stairs
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| mjl1717
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i think this is a classis type usmle q.
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| chemamr
forum moderator
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E, 
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