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PANCE Practice Question for March 29th

A 28-year-old man seeks help for progressive edema affecting his right lower extremity. It first started about 2 years ago but has become much worse in the last 6 months. Physical examination shows pitting edema from the groin to the toes, as well as very prominent varicose veins and an area of chronic cellulitis above the medial malleolus. These findings are confined to the right side and are not present at all on the left. He also is noted to have a palpable thrill and an audible bruit over the right groin. His resting pulse is 115/min. He gives a history of having suffered a gunshot wound to his right groin 3 years ago, for which he had no specific therapy.

Which of the following is the most likely diagnosis?

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