A 57-Year-Old Man Comes to the Physician for Evaluation of Pain

question 780

Multiple Choice

A 57-year-old man comes to the physician for evaluation of pain and swelling in his right leg.  He experienced pain in his right calf the night before that he thought was related to playing softball the previous day.  He recalled no injury while playing.  The pain progressed and he now has slight swelling in the right foot.  The patient has not had a similar problem previously.  He has no fever, chills, chest pain, or dyspnea.  His other medical problems include hypertension, hyperlipidemia, and degenerative joint disease of both knees.
Vital signs are normal.  There is 1+ pedal edema on the right leg and no edema on the left.  Peripheral pulses are full and symmetric.  There is no obvious difference in temperature between the legs.  There is no erythema or palpable cords.  Homan's sign is strongly positive on the right.  There may be a small effusion of the right knee.  The patient has nonpulsatile fullness in the right popliteal fossa when standing with his legs fully extended.
Which of the following is the most likely diagnosis?

• A)Deep venous thrombosis
• B)Popliteal artery aneurysm
• C)Popliteal synovial cyst
• D)Sarcoma
• E)Torn head of the gastrocnemius

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Definitions:

Callable Bonds

Bonds that can be redeemed by the issuer prior to their maturity date, usually at a predetermined price.

Future Interest Rates

An indication of what the cost of borrowing money or the rate of return on investments will be at a future date.

Callable Bonds

Bonds that give the issuer the right to redeem them before their maturity date at a pre-specified price.

Bond Indenture

The underlying contract between the company issuing bonds and the bondholders.