Answer A. Ankle-brachial pressure index: History and clinical examination should guide to the majority of the diagnosis of peripheral arterial disease. Sometimes, pulses can be difficult to assess, especially in obese people. In the primary care setting, an ankle-brachial pressure index can be measured. A value of less than 0.9 is indicative of peripheral arterial disease. The other options are all correct but would not be the initial investigations of choice in primary care. Duplex ultrasound is certainly first choice to look for stenosis if a patient is being considered for revascularisation therapy but would take longer to arrange.
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