A patient with deep vein thrombosis of the subclavian-axillary veins undergoes catheter-directed thrombolytic therapy. Completion venogram suggests mild narrowing of the subclavian vein at the site of a cervical rib. Which treatment decreases the likelihood of recurrent thrombosis?
A. Primary Stent
B. Rib Resection
C. Angioplasty
D. Provisional Stent
(Key = B)
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When running, an 18-year-old man has cramping in both calves that limits his ability to participate in football. Results of neurologic and musculoskeletal examinations are normal. Femoral, popliteal, and pedal pulses are normal. Ankle-brachial indices (ABI) are 1.1 bilaterally in the physician's office. Which of the following diagnostic tests would be most appropriate?:
A. Repeat ABI with plantar flexion against resistance.
B. Perform runoff angiography.
C. Perform supine and upright segmental pressure measurements.
D. Perform supine and upright segmental Doppler waveform pulse measurements.
(Key = A)
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An otherwise healthy, right-handed 47-year-old woman who does not smoke has three episodes of weakness and numbness of the right arm and leg and an inability to speak. The episodes last 5 to 10 minutes and then resolve. Carotid duplex ultrasonography reveals 60% to 79% stenosis in the middle and distal left internal carotid artery. Based on this arteriogram of the left internal carotid artery, what is the most likely diagnosis?:
A. Atherosclerotic stenosis
B. Giant cell arteritis
C. Medial fibroplasia
D. Intimal hyperplasia
(Key = C)
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Which patient should receive ultrasonographic screening for an abdominal aortic aneurysm?
A. A 70-year-old man with diabetes mellitus and a history of myocardial infarction
B. A 48-year-old man with polycystic kidney disease with a first-degree relative with an abdominal aortic aneurysm
C. A 65-year-old woman with a history of ruptured intracranial aneurysm
D. A 65-year-old man with a history of smoking
(Key = D)
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