Q: Which of the following laboratory findings would most strongly suggest a low risk of venous thromboembolism (VTE) in a patient with suspected deep vein thrombosis?

$$D\text{-}dimer \u003c 500 \ \mathrm{ng/ml}$$

Q: Which of the following is the correct formula for calculating LDL cholesterol in a fasting lipid panel?

$$LDL\text{-}C = \text{total cholesterol} - HDL\text{-}C - (\text{triglycerides}/5)$$

Question 1

A 52-year-old man presents with intermittent calf pain when walking that resolves with rest. On examination, his pedal pulses are weak. Which diagnostic test is most appropriate to confirm peripheral arterial disease (PAD), and what result would be consistent with this diagnosis?

Accepted Answer

Ankle:Brachial Index (ABI); result: $$ABI \u003c 0.9$$

Question 2

Which of the following best explains why fasting is required before obtaining a lipid panel for accurate measurement of LDL cholesterol?

Accepted Answer

Chylomicrons and IDL are cleared from the blood after fasting, allowing for accurate calculation of LDL using the formula $$LDL	ext{-}C = 	ext{total cholesterol} - HDL	ext{-}C - (	ext{triglycerides}/5)$$

Question 3

A patient with a history of familial hypercholesterolemia is found to have a total cholesterol of 600 mg/dL. Which genetic defect is most likely responsible for this finding?

Accepted Answer

Dysfunction of hepatic LDL receptors leading to decreased LDL uptake and elimination

Question 4

Which of the following is a primary (genetic) cause of hyperlipidemia?

Accepted Answer

Familial hypercholesterolemia (type 2a)

Question 5

A 65-year-old woman presents with a pulsating abdominal mass and mild abdominal pain. Which of the following is the most significant risk factor for the development of her condition?

Accepted Answer

Atherosclerosis

Question 6

Which of the following laboratory findings would most strongly suggest a low risk of venous thromboembolism (VTE) in a patient with suspected deep vein thrombosis?

Accepted Answer

$$D	ext{-}dimer \u003c 500 \ \mathrm{ng/ml}$$

Question 7

A 45-year-old man with a history of obesity and sedentary lifestyle develops a swollen, tender, and erythematous left calf. Which component of Virchow’s triad is most likely responsible for his condition?

Accepted Answer

Stasis of blood flow

Question 8

Which of the following best describes the pathophysiology of chronic venous insufficiency leading to skin changes in the lower extremities?

Accepted Answer

Venous hypertension leads to endothelial permeability, leukocyte and RBC extravasation, and hemosiderin deposition, resulting in tissue discoloration and fibrosis

Question 9

A 60-year-old man is diagnosed with atherosclerosis. Which of the following is a modifiable risk factor for this condition?

Accepted Answer

Obesity

Question 10

A patient is prescribed a statin for hyperlipidemia. What is the primary mechanism of action of statins?

Accepted Answer

Block cholesterol synthesis in the liver

Question 11

A 70-year-old woman presents with sudden onset of severe anterior chest pain radiating to her back. Imaging reveals a tear in the intimal layer of the ascending aorta. What is the most likely diagnosis?

Accepted Answer

Aortic dissection

Question 12

Which of the following medications is most appropriate for the prevention of arterial thrombosis in a patient with peripheral arterial disease?

Accepted Answer

Aspirin (ASA)

Question 13

A 35-year-old woman develops dilated, tortuous veins in her lower extremities after years of standing at her job. Which of the following best explains the pathogenesis of her condition?

Accepted Answer

Incompetent venous valves and failure of muscle pumps to overcome gravity

Question 14

A patient with a history of nephrotic syndrome develops hyperlipidemia. Which of the following best describes the mechanism of secondary hyperlipidemia in this patient?

Accepted Answer

Decreased hepatic LDL receptor production and increased hepatic lipoprotein synthesis

Question 15

Which of the following is the correct formula for calculating LDL cholesterol in a fasting lipid panel?

Accepted Answer

$$LDL	ext{-}C = 	ext{total cholesterol} - HDL	ext{-}C - (	ext{triglycerides}/5)$$

Question 16

A 58-year-old man with a history of hypertension and smoking presents with sudden onset of left leg pain, pallor, and pulselessness. Which vascular disorder is most likely responsible for his symptoms?

Accepted Answer

Acute arterial occlusion

Question 17

Which of the following is a common clinical manifestation of chronic venous insufficiency?

Accepted Answer

Brown pigmentation of the skin due to hemosiderin deposition

Question 18

A 40-year-old woman is found to have a D-dimer level of 800 ng/ml. What is the next best step in the evaluation of suspected venous thromboembolism (VTE)?

Accepted Answer

Order confirmatory imaging studies such as venous ultrasound

Question 19

A patient with a history of deep vein thrombosis is started on enoxaparin. Which coagulation factors are primarily inhibited by this medication?

Accepted Answer

Factors IIa and Xa

Disorders of Blood Flow: Hyperlipidemia, Atherosclerosis, and Vascular Pathology

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