American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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What condition is indicated by an Ankle-Brachial Index (ABI) of less than 0.4?

Tissue loss
Gangrene
Fusiform dilation of the CBD
Low CBD cyst

The correct answer is: Tissue loss

An Ankle-Brachial Index (ABI) of less than 0.4 indicates significant arterial insufficiency and is typically associated with critical limb ischemia. This level of ABI reflects severely reduced blood flow to the extremities, which can lead to tissue ischemia and subsequent loss. In this context, tissue loss refers to the damage or death of tissue due to insufficient blood supply, which often occurs in advanced peripheral artery disease. In the clinical setting, an ABI below 0.4 is a strong indicator that the patient may be at risk for ulceration, infection, and potentially amputation due to inadequate blood flow necessary for healing and tissue viability. Therefore, the selection of tissue loss aligns with the physiological state indicated by such a critical ABI value.