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Chronic venous insufficiency — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Chronic venous insufficiencyUSMLE Step 3

A 69-year-old man has bilateral lower-leg edema, hyperpigmentation, and aching worse at the end of the day. Pulses are intact. He has shallow ulcers near the medial malleoli. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Chronic venous insufficiency

Dependent edema, stasis changes, and medial malleolar ulcers suggest chronic venous insufficiency.

Reference: Society for Vascular Surgery venous disease guidance