What will be the diagnosis of Ramu, who is 45 year old male with history of chronic smoking and pain in lower limb due to blockage of femoral aery ?

Ans is 'b' ie Atherosclerosis A 45 yrs old male, chronic smoker is most likely to have atherosclerosis or TAO. Embolism is ruled as there is no likely source of emboli in this pt. (i.e. any hea ds as hea is the source of emboli for leg in 90% of the cases.) Aeritis rarely involves the lower limb vessels. Now Atherosclerosis Vs TAO Atherosclerosis is seen over 40 yrs of age (the highest incidence of atherosclerotic occlusive aerial ds in 6th & 7th decade) Where as TAO is seen in young male below 40 yrs of age. Atherosclerosis causes occlusion of large and medium sized vessels (Abdominal aoa, iliac aeries, femoral aeries, poplitial, tibial & peroneal aeries). TAO involves aeries of small & medium size (i.e. tibial aeries, plantar aries, radial aery) Symptoms of peripheral aerial insufficiency due to atherosclerosis is predominantly seen in lower extremity whereas TAO may cause symptoms in both upper or lower limbs. Thus this pt has Atherosclerosis as TAO does not involve popliteal or femoral vessels.