Which disease improves after quitting smoking, often seen with distal extremity ischemia?

Which disease improves after quitting smoking, often seen with distal extremity ischemia?

• A. Raynaud phenomenon
• B. Buerger disease
• C. Wegener's granulomatosis
• D. Varicose veins

Answer: (B)

This question hinges on a smoking-associated vascular disease that classically causes ischemia in the distal extremities and improves when the patient stops smoking. Buerger disease, also known as thromboangiitis obliterans, fits this pattern. It is a nonatherosclerotic inflammatory condition that predominantly affects small- and medium-sized arteries and veins of the arms and legs. The ensuing thrombosis can cut off blood flow to fingers and toes, leading to claudication, ulcers, and even gangrene. The strongest link to tobacco use makes quitting smoking the most effective intervention to halt progression and often improve symptoms. Other choices describe conditions that don’t rely on smoking cessation for improvement: Raynaud phenomenon is a vasospastic process, Wegener’s granulomatosis (granulomatosis with polyangiitis) is an autoimmune systemic vasculitis requiring immunosuppression, and varicose veins are venous, not primarily arterial, issues.

This question hinges on a smoking-associated vascular disease that classically causes ischemia in the distal extremities and improves when the patient stops smoking. Buerger disease, also known as thromboangiitis obliterans, fits this pattern. It is a nonatherosclerotic inflammatory condition that predominantly affects small- and medium-sized arteries and veins of the arms and legs. The ensuing thrombosis can cut off blood flow to fingers and toes, leading to claudication, ulcers, and even gangrene. The strongest link to tobacco use makes quitting smoking the most effective intervention to halt progression and often improve symptoms. Other choices describe conditions that don’t rely on smoking cessation for improvement: Raynaud phenomenon is a vasospastic process, Wegener’s granulomatosis (granulomatosis with polyangiitis) is an autoimmune systemic vasculitis requiring immunosuppression, and varicose veins are venous, not primarily arterial, issues.