Smoking and amputated digit!
30 year old smoker that had been smoking since teenage has painful thrombosis of the superficial veins of the leg for a month then she experienced episodes when her fingers get blue & cold. over the next year she developed chronic ulcerating poor healing in her feet, one finger developed gangrene and need amputation. hostologically at resection margin there is acute & chronic vasculitis of medium sized arteries with segmental involvement, what u should advice her
a. hemodialysis is necessary
b. she must stop smoking
c. corticosteroid will be effective in her case
d. antibiotic therapy for syphilis
e. insulin therapy to control her disease