Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            urning feeling. 
✓ Swelling. 
✓ Bulging veins. 
✓ Ulceration  
 
the complications of venous disease: 
1) Superficial thrombophlebitis. 
2) Varicose veins 
3) Deep vein thrombosis. 
4) Chronic venous insufficiency  
5) Pulmonary embolism. 
6) Venous ulcers: complicated by Infections or gangrene. 
 د.أحمد صباح 
Surgery 
     كلية مدينة العلم الجامعة 
 
 
5 
Venous Disease Treatment 
1) Lifestyles changes, to avoid smoking, control of diabetes and stop oral contraceptives pill and 
weight reduction in case of obesity. 
2) Early mobilization, walking and adequate hydration following surgery. 
3) Compression stockings or bandages. 
4) Medications: Anticoagulants examples Low molecular weight heparin (LMWH) and warfarin. 
5)  Procedures or surgeries: 
a) Endo venous ablation of varicose veins (with lasers, sclerotherapy or radiofrequency). 
b) Thrombectomy. 
c) Vena cava filter. 
d) Vein surgery 
 
 
 
 
 
Varicose vein surgery  
 د.أحمد صباح 
Surgery 
     كلية مدينة العلم الجامعة 
 
 
6 
 
---------------------------------------------------------------------------------------------------- 
Thrombophlebitis 
➔ Clinical Definition: a thrombotic disorder characterized by thrombi and inflammation 
(phlebitis) in the superficial veins 
➔ Pathogenesis: endothelial injury can trigger thrombus formation and inflammatory 
response 
➔ common in women > men 
➔ more common in adults 
➔ most commonly in the lower extremities 
➔ can also occur at sites of trauma (e.g., sites of intravenous catheters) 
➔ Associated conditions: deep venous thrombosis. 
 
 
 
 د.أحمد صباح 
Surgery 
     كلية مدينة العلم الجامعة 
 
 
7 
Risk Factors 
Same as risk factors for venous disease 
Presentation 
Symptoms:  pain of the involved site 
Physical exam 
 erythema and edema along the vein. 
 tenderness along the vein. 
 palpable thickened or thrombosed vein. 
 visibly distended veins. 
Complication 
1. Progression to deep venous system 
2. pulmonary embolism 
investigation  
1. Blood coagulation studies 
2. Doppler ultrasound 
3. Venography 
 
Doppler ultrasound 
 
 
Treatment 
 Treatment includes analgesia, elevation and compression. 
 Anticoagulation is usually not usually indicated unless process involves deep venous system. 
 
 
 
 د.أحمد صباح 
Surgery 
     كلية مدينة العلم الجامعة 
 
 
8 
Pulmonary Embolism 
 is mechanical obstruction of the pulmonary vasculature secondary to a blood clot 
 DVT is  most common cause from the veins of the proximal thigh (iliac, femoral, or popliteal) 
 
symptoms of a pulmonary embolism 
✓ Shortness of breath. 
✓ Chest pain. 
✓ Tachypnea 
✓ Tachycardia (Fast heartbeat) 
✓ Cough. 
✓ Hemoptysis 
✓ Cyanosis  
 
 


            Quiz: