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Thread: what is it?

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    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    what is it?

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    A 55-year-old woman consults a physician because of edema involving her lower legs. While both of her ankles are swollen, the left one is much more swollen than the right. Physical examination additionally demonstrates a swollen, tender, bluish, cord-Iike structure immediately below the skin on her left lower leg extending from her ankle to near her knee. Edema at sites other than the ankles is not apparent on physical examination. The patient has not been having any other symptoms. The woman works as a nurse and had a long airplane trip during the previous week.

    The tender cord-Iike structure is most likely which of the following?
    / A. Artery
    / B. Ligament
    / C. Lymphatic channel
    / D. Tendon
    / E. Vein
    Last edited by IMG SURVIVOR; 10-25-2008 at 10:18 PM.
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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    IMG SURVIVOR's Avatar
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    The correct answer is E. The structure is most likely an inflamed vein. Large superficial veins are common on the legs.
    The superficial arteries (choice A) of the legs are usually much less apparent and located deeper than are the veins.
    Ligaments (choice B) attach bone to bone, and can be palpated, but not usually seen, in the feet and at the knee.
    Lymphatic channels (choice C) are usually invisible on surface examination, unless they are markedly inflamed and accompanied by skin erythema. Then they appear as red lines.
    Tendons (choice D) also produce cord-like structures, but they are pale in color and do not appear blue through the skin.
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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