Rosh Internal Medicine Boost Practice Exam

What does a falsely high ankle-brachial index indicate regarding leg vessels?

1. Indicates peripheral venous insufficiency

2. Indicates severe disease

3. Indicates severely hardened, non-compressible leg vessels

4. It is the ratio of ankle to arm diastolic blood pressure

The correct answer is: Indicates peripheral venous insufficiency

A falsely high ankle-brachial index (ABI) primarily indicates the presence of severely hardened, non-compressible leg vessels, which is typically due to calcification in conditions such as diabetes or chronic kidney disease. When the arteries are calcified, they become rigid and do not compress during the measurement process, leading to inaccurately elevated readings. The ankle-brachial index is a comparison of the blood pressure in the ankle to the blood pressure in the arm, and a normal or low reading indicates good blood flow. However, when the ABI is falsely elevated, it suggests an underlying issue with the leg vessels that prevents accurate assessment. This representation is crucial in understanding vascular health and the potential presence of peripheral artery disease, which may not be detected if the ABI is misleadingly high. In the context of peripheral venous insufficiency, this condition primarily affects the veins rather than the arteries and does not directly lead to a falsely high ABI. Severe disease in general could mean various conditions but doesn't specifically relate to the falsely elevated ABI. The ratio mentioned does not accurately reflect the interpretation of ABI in this scenario.