Vascular surgery: ruptured AAA: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Vascular surgery: ruptured AAA

Sample item

A 72-year-old with sudden severe back pain, collapse and a pulsatile abdominal mass has a systolic BP of 80 mmHg. What is the best initial approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Permissive hypotension with immediate transfer to theatre for repair

The triad of pain, hypotension and a pulsatile mass indicates rupture. Excess fluid raises pressure, dislodges clot and worsens haemorrhage, so permissive hypotension (about 70 to 90 mmHg) is accepted and emergency repair, EVAR if anatomy suits, follows without delay.

Option by option

  • A. Conservative management

    Mortality is nearly certain without repair.

  • B. CT after full stabilisation over several hours

    Delay for imaging in an unstable patient is dangerous.

  • C. Permissive hypotension with immediate transfer to theatre for repair (correct)

    Correct. Rapid control with permissive hypotension is vital.

  • D. Aggressive crystalloid to reach systolic 140 mmHg before surgery

    Over-resuscitation worsens bleeding.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Permissive hypotension with immediate transfer to theatre for repair. The triad of pain, hypotension and a pulsatile mass indicates rupture.

Why is "Conservative management" not the answer?

Mortality is nearly certain without repair.

Why is "CT after full stabilisation over several hours" not the answer?

Delay for imaging in an unstable patient is dangerous.

Why is "Aggressive crystalloid to reach systolic 140 mmHg before surgery" not the answer?

Over-resuscitation worsens bleeding.

What concept does this question test?

It tests Vascular surgery: ruptured AAA in General Surgery. Excess fluid raises pressure, dislodges clot and worsens haemorrhage, so permissive hypotension (about 70 to 90 mmHg) is accepted and emergency repair, EVAR if anatomy suits, follows without delay.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vascular surgery: ruptured AAA?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.