Surgery Form 3 - More Help Needed! - ssg725

[ArchivalUser]

A 57 yo M comes to the physician b/c of a 3 mo hx of increasing pain in his calves when he walks more than 1/2 mile. The pain resolves after 5 min of rest, and he can walk 1/2 mile before the pain returns. He has smoked 1 pack of cigarettes daily for 40 yrs. He has a 10 year hx of hypertension well controlled with hydrocholothiazide and atenolol. His temp is 37 degC (98.6 deg F), pulse is 84/min, RR 12/min, and BP 140/85 mm Hg. Popliteal, dorsalis pedis, and posterior tibialis pulses are slightly decreased; femoral pulses are normal. Measurement of ABI shows a ratio of 0.8 (n>1). In addition to recommending smoking cessation, which of the following is the most appropriate next step in management?

A) Recommend a walking program.
B) CT scan of lumbar spine
C) MRI of calf
D) Aspirin therapy
E) Aortic angiography

I know for sure that it is not D or E (My friend and I both were wrong). So it's either A, B, or C. B seems bizarre, so I feel like it is either A or C, but all of my study resources recommend Doppler, CT Angio, or at the very least, aspirin therapy, so I am very confused.

Thank you!

[ArchivalUser]

it is A.

Exercise therapy really helps those folks. Similar question is in u world

[ArchivalUser]

Awesome, thank you so much!!

Out of curiosity, any reason why D (aspirin) isn't a better answer? It just seems like more of a reliable method of prevention vs. asking the pt to walk more!

[ArchivalUser]

the thing is that you give that pt aspirin because you know that IF he has peripheral arterial disease - he definitely also has heart problems- so you want to prevent MI. Aspirin doesn't really do anything to his legs though. So you recommend exercise to kinda increase blood supply in those legs and keep it going. Of course you will give Aspirin, but if you see a question like this with pt with claudication - answer exercise, if you don't have exercise as an option - go with Aspirin