Chronic Venous Disease

Question 1

Which of the following characterizes primary varicose veins?
A. Result from venous hypertension due to deep venous obstruction.
B. Caused by defective valves and high intraluminal pressure in superficial veins.
C. Caused by incompetent perforating veins exclusively.
D. Always associated with a history of deep vein thrombosis (DVT).

Answer 1

B

Question 2

Which of the following is a common cause of secondary deep venous insufficiency?
A. High venous pressure due to pregnancy.
B. Valvular reflux in the great saphenous vein.
C. Previous deep vein thrombosis leading to valve damage.
D. Incompetence of superficial veins only.

Answer 2

C

Question 3

Which syndrome is caused by extrinsic compression of the left iliac vein by the right common iliac artery?
A. Klippel-Trénaunay syndrome.
B. May-Thurner syndrome.
C. Parkes-Weber syndrome.
D. Thoracic outlet syndrome.

Answer 3

B

Question 4

A 45-year-old woman presents with leg heaviness and swelling after prolonged standing, relieved by elevation. Which condition is most likely?
A. Peripheral arterial disease.
B. Chronic venous insufficiency.
C. Acute DVT.
D. Lymphedema

Answer 4

B

Question 5

Which clinical finding is most suggestive of advanced chronic venous insufficiency?
A. Edema confined to the ankles.
B. Pitting edema that becomes indurated over time.
C. Hyperpigmentation localized to the thigh.
D. Telangiectasias without associated skin changes.

Question 6

What is the characteristic feature of a venous ulcer?
A. Deep, punched-out appearance with black eschar.
B. Irregular borders, shallow base with granulation tissue and exudate.
C. Non-healing with pale granulation tissue and absent exudate.
D. Presence of erythematous streaking with lymphadenopathy.
Answer: B

Answer 6

B

Question 7

What is the principal diagnostic test for chronic venous disease?
A. Magnetic resonance venography.
B. Venous duplex ultrasonography.
C. Plethysmography.
D. Conventional venography.

Answer 7

B

Question 8

What does the absence of venous collapse on ultrasound compression indicate?
A. Superficial venous insufficiency.
B. Venous obstruction due to thrombus.
C. Physiologic venous flow.
D. Valve competence in deep veins.

Answer 8

B

Question 9

Which compression stocking pressure is most appropriate for healing venous ulcers?
A. 10–20 mmHg.
B. 20–30 mmHg.
C. 30–40 mmHg.
D. 40–50 mmHg.

Answer 9

C

Question 10

Which ablative therapy delivers thermal energy to promote venous occlusion?
A. Cyanoacrylate tissue adhesive.
B. Mechanochemical ablation.
C. Endovenous laser therapy.
D. Sclerotherapy.

Answer 10

C

Question 11

Which sclerosing agent is approved by the FDA for varicose vein treatment?
A. Sodium tetradecyl sulfate.
B. Hydrogel polymer.
C. Cyanoacrylate adhesive.
D. Polyurethane foam.

Answer 11

A

Question 12

Which surgical procedure is used to treat valvular incompetence by tightening the valve through commissural apposition?
A. Stab phlebectomy.
B. Valvuloplasty.
C. SEPS.
D. Saphenopopliteal vein bypass.

Answer 12

B

Question 13

Which of the following best describes the pathophysiology of lymphedema?
A. Excessive arterial blood flow due to increased pressure.
B. Imbalance between lymph production and lymph absorption.
C. Reduced interstitial osmotic pressure.
D. Loss of venous valve function.

Answer 13

B

Question 14

What is the purpose of lymphatic valves?
A. Promote arterial blood flow.
B. Enhance absorption of interstitial proteins.
C. Ensure unidirectional lymphatic flow.
D. Facilitate venous return.

Answer 14

C

Question 14

Which gene mutation is associated with Milroy’s disease?
A. FOXC2.
B. VEGFR3.
C. SOX18.
D. GATA2.

Answer 14

B

A. FOXC2 ymphedema-distichiasis syndrome
C SOX18 hypotrichosis, lymphedema, telangiectasia syndrome
D GATA2 AML

Question 15

What is the most common worldwide cause of secondary lymphedema?
A. Lymphogranuloma venereum.
B. Podoconiosis.
C. Lymphatic filariasis.
D. Surgical excision of lymph nodes.

Answer 15

C

Question 16

Which of the following describes lymphedema praecox?
A. Onset at birth due to congenital lymphatic abnormalities.
B. Onset during puberty with potential autosomal dominant inheritance.
C. Onset after 35 years of age with sporadic genetic mutations.
D. Onset due to secondary causes such as lymph node dissection.

Answer 16

B

Question 17

What syndrome is characterized by a double row of eyelashes and lymphedema?
A. Meige’s disease.
B. Milroy’s disease.
C. Lymphedema-distichiasis syndrome.
D. Klippel-Trénaunay syndrome.

Answer 17

C

Question 18

What is the typical progression of lymphedema in the lower extremity?
A. Begins in the thigh and spares the toes.
B. Involves the foot initially and progresses upward.
C. Affects only the toes.
D. Starts as non-pitting edema in the thigh.

Answer 18

B

Question 19

What is Stemmer’s sign?
A. Pitting edema that improves with elevation.
B. Inability to tent the skin at the base of the toes.
C. Dimpling of the skin resembling an orange peel.
D. Presence of a honeycomb pattern on MRI.

Answer 19

B

Question 20

Which term describes the orange-peel-like dimpling of the skin in chronic lymphedema?
A. Peau d’orange.
B. Lipodermatosclerosis.
C. Hypotrichosis.
D. Atrophie blanche.

Answer 20

A

Question 21

What feature distinguishes lipedema from lymphedema?
A. Pitting edema in the early stages.
B. Edema with sparing of the feet.
C. Square toes in the affected limb.
D. Honeycomb pattern on MRI.

Answer 21

B

Question 22

Which imaging modality can reveal a honeycomb pattern characteristic of lymphedema?
A. Lymphoscintigraphy.
B. Magnetic resonance imaging (MRI).
C. Computed tomography (CT).
D. Ultrasound.

Answer 22

B

Question 23

What finding on lymphoscintigraphy is indicative of secondary lymphedema?
A. Absence of lymphatic channels.
B. Dilated lymphatic vessels distal to obstruction.
C. Hypoplastic lymphatic vessels.
D. Dermal backflow.

Answer 23

B

Question 24

Which of the following treatments is contraindicated in lymphedema?
A. Multilayered compressive bandages.
B. Manual lymphatic drainage.
C. Diuretics.
D. Intermittent pneumatic compression devices.

Answer 24

C

Question 25

What is the purpose of multilayered compressive bandages in lymphedema?
A. Prevent infections.
B. Reduce recurrent edema
C. Promote angiogenesis.
D. Reduce intravascular volume.

Answer 25

B

Question 26

Which therapeutic approach involves rerouting lymphatic flow into the venous system?
A. Limb reduction surgery.
B. Lymphaticovenous anastomosis.
C. Liposuction.
D. Decongestive physiotherapy.

Answer 26

B