The patient lives with his wife and two sons who are all well, and works as a gas station attendant. He does not exercise regularly. Physical examination reveals an abdominally obese male, in no distress. The fundi are not clearly seen. His chest is clear and the cardiovascular exam is normal to auscultation.
Peripheral pulses are present but pedal pulses are weak.
A faint femoral bruit is heard on the left side. Deep tendon reflexes are all intact with the exception of absent ankle reflexes. All rights reserved.