DPM Vascular & Neurological Conditions of the Lower Extremity Flashcards

What is Morton's neuroma?

Answer: Perineural fibrosis of an interdigital plantar nerve, most often in the third web space

Morton's neuroma is not a true neuroma but perineural fibrosis of the interdigital plantar nerve, most commonly in the third web space between the third and fourth toes.

Which physical examination maneuver elicits a palpable click and pain in Morton's neuroma?

Answer: Mulder's click test

Mulder's click test involves compressing the metatarsal heads while pressing on the web space; a painful click confirms Morton's neuroma.

Chronic venous insufficiency characteristically produces skin changes known as:

Answer: Atrophie blanche and lipodermatosclerosis around the medial malleolus

Chronic venous insufficiency causes hemosiderin deposition (brown pigmentation), lipodermatosclerosis (fibrotic induration), and atrophie blanche predominantly around the medial malleolus.

Which imaging modality is the first-line study for evaluating peripheral arterial occlusive disease?

Answer: Duplex ultrasound

Duplex ultrasound (B-mode imaging with Doppler flow analysis) is the first-line non-invasive test for evaluating the site and severity of peripheral arterial disease.

Which condition causes acute lower extremity deep vein thrombosis (DVT) and requires immediate anticoagulation?

Answer: Proximal DVT involving the popliteal or femoral vein

Proximal DVT involving the popliteal or femoral veins carries significant risk of pulmonary embolism and requires immediate anticoagulation therapy.

Which clinical sign, a palpable thrill or audible bruit in the groin or femoral region, suggests:

Answer: Significant arterial stenosis or arteriovenous fistula

A bruit (audible turbulence) or thrill (palpable vibration) over an artery indicates turbulent flow due to significant stenosis or an arteriovenous fistula.