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Review Question - QID 100580

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QID 100580 (Type "100580" in App Search)
A 46-year-old female waitress presents to your office complaining of painful, tortuous veins and a feeling of "fullness" in her legs. A photograph of her legs is seen in Figure A. Which of the following is most likely abnormal in this patient?
  • A

Hydrostatic blood pressure

5%

4/83

Aortic valve

1%

1/83

Endothelial tight junctions

1%

1/83

Venous valves

89%

74/83

Collagen synthesis

1%

1/83

  • A

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The patient's presentation and image is consistent with varicose veins. Varicose veins are a result of dysfunctional venous valves.

Valvular incompetence leads to distal venous dilation and abnormal blood flow contributing towards the characteristic enlarged and tortuous appearance. They are more prevalent in women and occur most often in the superficial veins of the legs. Prolonged standing can worsen their appearance. In addition to being aesthetically displeasing, the varicose veins can be quite painful.

Jones and Carek review the management of varicose veins. Conservative treatment options include: avoidance of prolonged standing, external compression garments, leg elevation, exercise and weight loss. More aggressive treatment includes: injection sclerotherapy, external lasers, and surgery.

Hamdan reviews varicose veins and venous insufficiency in JAMA. Symptoms of chronic venous disease range from cosmetic spider veins to large painful varicose veins, lipodermatosclerosis of the skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulceration.

Figure A is a photograph depicting varicose veins in the legs of the patient.

Illustration A highlights the differences between normal and varicose veins.

Incorrect Answers:
None of these are responsible for the development of varicose veins.

ILLUSTRATIONS:
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