American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following therapies is usually reserved for patients with chronic venous insufficiency who have failed conservative management?

1. Compression stockings

2. Ablation therapy

3. Oral diuretics

4. Physical therapy

The correct answer is: Ablation therapy

Ablation therapy is a minimally invasive procedure used to treat chronic venous insufficiency, particularly in cases where conservative management options, such as compression stockings, have not provided sufficient relief or improvement in symptoms. Chronic venous insufficiency can lead to symptoms like leg swelling, pain, and skin changes, and when these symptoms persist despite initial treatment efforts, ablation therapy becomes an appropriate option. The procedure targets the affected veins, typically using laser or radiofrequency energy to close off the dysfunctional vein, redirecting blood flow to healthier vessels. This approach can significantly improve symptoms and prevent complications associated with chronic venous disease, such as ulcers or thrombosis. In contrast, compression stockings are standard initial therapy for chronic venous insufficiency and aim to reduce symptoms by improving venous return, while oral diuretics are not typically used as a primary treatment for venous insufficiency but may be employed for managing related issues, like edema, when necessary. Physical therapy can provide supportive care but does not directly address the underlying venous insufficiency. Therefore, ablation therapy is specifically designated for patients who do not respond adequately to these conservative measures.