Question

A 44 year old patient comes to the clinic with discomfort in his legs. He has a history of smoking and hyperlipidemia. He states that the pain in his legs worsen when walking but resolves with rest. Upon assessment the nurse practitioner notes gangrenous toes. The patients ankle-brachial index score is 0.8. What does this score indicate?

a. Score of 0.8 is diagnostic for peripheral arterial disease
b. Score of 0.8 is non-diagnostic for peripheral arterial disease
c. Score of 0.8 is diagnostic for peripheral venous disease
d. Score of 0.8 is non-diagnostic for peripheral venous disease

Answer 1

An ABI score of 0.8 in a patient with leg discomfort, a history of smoking, and hyperlipidemia, along with the observation of gangrenous toes, is diagnostic for peripheral arterial disease (PAD). This condition is linked to atherosclerosis and requires prompt treatment to prevent further complications.

Step-by-step explanation:

A 44-year-old patient comes to the clinic with discomfort in his legs, has a history of smoking and hyperlipidemia, and experiences leg pain that worsens with walking but resolves with rest. The nurse practitioner observes gangrenous toes, which is a serious condition often associated with peripheral arterial disease (PAD), a condition resulting from the narrowing of peripheral arteries due to atherosclerosis. This condition often presents with intermittent claudication, which matches the patient's symptoms of pain during walking that resolves with rest.

The patient's ankle-brachial index (ABI) score is reported to be 0.8. The ABI is a diagnostic tool used to assess the presence of PAD by comparing the blood pressure in the ankle with that in the arm. An ABI score below 0.9 is indicative of PAD. Therefore, an ABI score of 0.8 is diagnostic for peripheral arterial disease (PAD). Given the patient's history, symptoms, and ABI score, a diagnosis of PAD is likely.

It is imperative to treat PAD promptly to manage symptoms and reduce the risk of complications. Management would involve lifestyle changes, medication, and possibly surgical intervention, depending on the severity of the condition.