This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Ramu, a 40 years old male, a chronic smoker presents with claudication and a medial leg ulcer. For the past one month, he is having rest pain. Which of the following procedures would not relieve his rest pain - \nSelect and explain. \nA. Lumbar Sympathectomy, B. Omentoplaxy, C. Conservative Amputation, D. Femoropopliteal bypass', 'role': 'user'}, {'content': "Answer: D \nExplanation: This patient is suffering from Buergers ds (also k/a Thromboangitis obliterans)\nBuergers ds is characterized by occlusive disease of the small and medium-sized arteries* (planters, tibialis and radial artery), thrombophlebitis of the superficial or deep veins and Raynaud's syndrome.\nAs Buerger's disease involves the arteries beyond the popliteal artery, there would be no help from a femoropopliteal bypass. It is helpful if the artery is blocked proximally as in atherosclerosis.\nNot only femoro-popliteal bypass operation but any vascular reconstructive operation is not feasible in Buerger's ds, because the involvement of the small vessels of the extremity makes it difficult to locate suitable outflow sites for bypass grafts.\n\nTreatment of Buergers ds\n\nStop smoking\nSympathectomy\xa0→ is used with some success.\nAmputation\xa0→\xa0 is the only way out when gangrene occurs.\nFree omental graft\xa0→ Microvascular transplantation of free omental grafts to areas not\n\tamenable to arterial reconstruction has been successfully tried.\nIt appears that conservative amputation should not be used in this pt. who does not have gangrene, but a femoro-popliteal bypass has no role whatsoever and is the better answer out of the two options. Amputation can be used to relieve the patient of persisting rest pain.", 'role': 'assistant'}]