Question

A male pt has s/sxs of intermittent claudication, unilateral pain in the buttock and thigh (Sometimes exacerbating bilaterally), and a diminished femoral pulse. His pain is relieved by rest. Based on the clinical presentation, where is the site of the occlusion?

A) Aortic bifurcation
B) Iliac artery
C) Femoral and popliteal artery
D) Tibial and common peroneal artery

Answer 1

Based on the presentation of intermittent claudication, unilateral pain in the buttock and thigh, and a diminished femoral pulse that improves with rest, the site of occlusion is likely at the aortic bifurcation or the iliac artery, which can affect blood flow to the femoral artery and lead to these symptoms.

Step-by-step explanation:

The patient's symptoms of intermittent claudication, unilateral pain in the buttock and thigh, occasionally exacerbating bilaterally, along with a diminished femoral pulse that improves with rest, are most indicative of an arterial occlusion involving the aortic bifurcation (A) or iliac artery (B). Considering the presentation, the site of occlusion is most likely at the aortic bifurcation, where the aorta divides into the iliac arteries, or directly at one of the iliac arteries. When the aortic bifurcation or iliac artery is involved, it can affect blood flow to the femoral artery as well, resulting in symptoms felt in the regions supplied by these arteries, including the buttock and thigh, with a diminished femoral pulse being a key clinical sign. Since the pain may exacerbate bilaterally, this also supports the likelihood of a higher level occlusion, such as at the aortic bifurcation, where arterial supply can be affected on both sides.