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Question

Which of the following is NOT a symptom of atherosclerotic occlusive disease at the bifurcation of aorta (Leriche syndrome)?

The correct answer is
Gangrene localised to the feet

Leriche Syndrome: Understanding Symptoms

Leriche syndrome is characterized by atherosclerosis specifically affecting the bifurcation of the aorta. This condition impairs blood flow to the pelvic organs and lower limbs. Key symptoms arise directly from this reduced circulation.

Analyzing Leriche Syndrome Symptoms

  • Claudication of the buttock and thigh: This is a hallmark symptom. The blockage at the aortic bifurcation directly restricts blood supply to the gluteal and femoral arteries, causing pain during activity.
  • Claudication of the calf: Reduced blood flow resulting from the aortic bifurcation blockage can also affect circulation to the lower leg, leading to calf pain upon exertion.
  • Sexual impotence: This is a significant symptom as the iliac arteries branching from the aorta supply the pelvic region. Atherosclerosis at the bifurcation impedes blood flow necessary for erectile function.
  • Gangrene localised to the feet: While gangrene represents critical limb ischemia and can be a consequence of severe peripheral artery disease, it is often considered a severe complication or manifestation of distal disease rather than a primary symptom directly defining the condition at the aortic bifurcation itself. Symptoms like claudication and impotence are more direct indicators of the blockage's location.

Identifying the Non-Symptomatic Sign

Among the options provided, claudication (in the buttock, thigh, and calf) and sexual impotence are direct consequences of atherosclerotic occlusion at the aorta's bifurcation. Gangrene, while a possible severe outcome of compromised blood flow, is less specific as a primary symptom compared to the others.

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Important Questions from Blood Vessels

  1. A 48-year-old smoker presents to the OPD with complaints of cramping pain in both the calves on walking to about 100-150 metres. The pain is relieved on taking rest for about 2-3 minutes and the patient is able to walk for some more distance again before the pain appears. This presentation is suggestive of
  2. Indications for carotid endarterectomy in symptomatic patients are all of the following EXCEPT:
  3. A policeman of 45 years presented with Lipodermatosclerosis over lower medial aspect of left leg, along with a healed venous ulcer. As per the CEAP (Clinical-etiology-anatomy-pathophysiology) classification his clinical classification will be:
  4. Consider the following statements regarding claudication:
    1. It is a marker for silent coronary disease
    2. Structured exercise program ( 2 hours per week for 3 months) leads to improvement in symptoms
    3. Diabetes mellitus increases the risk and severity of claudication
    4. Beta blockers may exacerbate claudication
    Which of the above statements are correct?

  5. On second day following femoral embolectomy, the leg is found to be tender, tense and dusky with feeble dorsalis pedis. The most appropriate management would be:
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