Vascular surgery: 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

Sample item

A 68-year-old man with atrial fibrillation not on anticoagulation has sudden severe central abdominal pain, but the abdomen is soft with only minimal tenderness. Lactate is high. What is the investigation of choice?

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

The answer and the reasoning

B. CT angiography of the abdomen

Pain out of proportion to the findings in an embolic-risk patient suggests acute mesenteric ischaemia, usually from a superior mesenteric artery embolus. CT angiography is the preferred test, and treatment is urgent revascularisation, resection of non-viable bowel and anticoagulation. Delay increases mortality.

Option by option

  • A. Serum amylase only

    A normal or mildly raised amylase would not exclude ischaemia.

  • B. CT angiography of the abdomen (correct)

    Correct. CT angiography confirms and localises mesenteric arterial occlusion.

  • C. Barium meal

    Barium meal is not appropriate in an acute abdomen.

  • D. Erect chest X-ray

    An erect chest film may show free air but cannot diagnose mesenteric ischaemia.

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 B, CT angiography of the abdomen. Pain out of proportion to the findings in an embolic-risk patient suggests acute mesenteric ischaemia, usually from a superior mesenteric artery embolus.

Why is "Serum amylase only" not the answer?

A normal or mildly raised amylase would not exclude ischaemia.

Why is "Barium meal" not the answer?

Barium meal is not appropriate in an acute abdomen.

Why is "Erect chest X-ray" not the answer?

An erect chest film may show free air but cannot diagnose mesenteric ischaemia.

What concept does this question test?

It tests Vascular surgery in General Surgery. CT angiography is the preferred test, and treatment is urgent revascularisation, resection of non-viable bowel and anticoagulation. Delay increases mortality.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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?

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.