Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

What characterizes the pain of PVD claudication compared to spinal stenosis?

1. Stopping ambulation improves pain

2. Bilateral and easy to localize

3. Persistent pain all day

4. Worse when sitting down

The correct answer is: Stopping ambulation improves pain

The pain associated with peripheral vascular disease (PVD) claudication is characterized by its nature and resolution. The correct response indicates that stopping ambulation, or resting, effectively alleviates the pain experienced during claudication. This phenomenon occurs because claudication pain is due to inadequate blood flow to the muscles during exertion, which results in ischemic pain. When the individual stops walking and rests, blood flow is restored, and the pain subsides. In contrast, spinal stenosis could lead to pain that does not immediately improve with rest, as symptoms may persist even when activity ceases. Patients with spinal stenosis often find that symptoms can be relieved by positioning themselves in a flexed position (like sitting) rather than simply stopping movement. The other choices do not accurately describe the pain characteristics associated with claudication. For example, claudication pain is typically unilateral depending on vascular supply, and while it does have an acute start during activity, it does not persist all day. Instead, it is episodic, triggered by exertion and relieved by rest. This key distinction helps differentiate PVD claudication from spinal stenosis and contributes to appropriate diagnostic and treatment considerations.