In which condition is leg pain produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest?

Diuretics are drugs that increase the amount of urine and salt (sodium) excreted by the kidneys. They are used to treat high blood pressure, heart failure, and edema (fluid retention). However, some diuretics can cause low levels of potassium in the blood (hypokalemia), which can lead to muscle weakness, cramps, and arrhythmias. To prevent this, a combination of diuretics acting on different parts of the kidney (such as a loop diuretic and a thiazide diuretic) may be prescribed.This way, the potassium-sparing effect of one diuretic can balance the potassium-wasting effect of the other, while still achieving a net sodium loss.

Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who are resistant to or intolerant of monotherapy.

Choice C is wrong because little follow up is not needed after the initial treatment.Patients on combination diuretic therapy require close monitoring of their blood pressure, electrolytes, renal function, and weight to avoid adverse effects such as dehydration, hyponatremia, hypotension, and worsening renal function.

Choice D is wrong because they do not increase the risk of hypokalemia.As explained above, combination diuretic therapy aims to reduce the risk of hypokalemia by using a potassium-sparing diuretic along with a potassium-wasting diuretic.

Normal ranges for serum potassium are 3.5 to 5.0 mmol/L and for serum sodium are 135 to 145 mmol/L.

Intermittent claudication is a condition in which leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest. This is because the blood flow to the leg muscles is insufficient to meet the increased demand during exercise, but adequate at rest.Intermittent claudication is a common symptom of peripheral artery disease (PAD), which is a narrowing of the arteries that supply blood to the legs.

Choice B, sporadic ischemia, is wrong because it is not a specific medical term for a condition that causes leg pain.

Ischemia means reduced blood flow to a part of the body, which can cause pain, but it can be caused by various factors and affect different organs.

Choice C, angina, is wrong because it is a term for chest pain caused by reduced blood flow to the heart, not the legs.

Angina can also be triggered by physical activity and relieved by rest, but it is not related to PAD or leg ischemia.

Choice D, restless leg syndrome, is wrong because it is a condition that causes an uncomfortable urge to move the legs, usually at night or when lying down.

Restless leg syndrome does not cause pain or ischemia in the legs, and it is not improved by rest.It is thought to be related to a problem with the nervous system or iron deficiency.