Intestinal obstruction: strangulation: 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 · Intestinal obstruction: strangulation

Sample item

In a patient with small bowel obstruction, which finding most suggests strangulation?

AConstant severe pain with fever, tachycardia and localised tendernessBColicky pain that comes in waves with high-pitched bowel soundsCAbsolute constipation aloneDVomiting with visible peristalsis

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

The answer and the reasoning

A. Constant severe pain with fever, tachycardia and localised tenderness

Strangulation compromises blood supply, causing continuous pain, systemic inflammatory response, peritonism and leucocytosis with raised lactate. Colic with visible peristalsis is simple obstruction. Strangulation demands early operation to avoid gangrene and perforation.

Option by option

A. Constant severe pain with fever, tachycardia and localised tenderness (correct)
Correct. Continuous pain with toxicity indicates ischaemic bowel.
B. Colicky pain that comes in waves with high-pitched bowel sounds
Colicky pain with hyperactive sounds is typical of simple mechanical obstruction.
C. Absolute constipation alone
Absolute constipation occurs in simple obstruction too.
D. Vomiting with visible peristalsis
Visible peristalsis shows active attempts to overcome the obstruction.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Constant severe pain with fever, tachycardia and localised tenderness. Strangulation compromises blood supply, causing continuous pain, systemic inflammatory response, peritonism and leucocytosis with raised lactate.

Why is "Colicky pain that comes in waves with high-pitched bowel sounds" not the answer?

Colicky pain with hyperactive sounds is typical of simple mechanical obstruction.

Why is "Absolute constipation alone" not the answer?

Absolute constipation occurs in simple obstruction too.

Why is "Vomiting with visible peristalsis" not the answer?

Visible peristalsis shows active attempts to overcome the obstruction.

What concept does this question test?

It tests Intestinal obstruction: strangulation in General Surgery. Colic with visible peristalsis is simple obstruction. Strangulation demands early operation to avoid gangrene and perforation.

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 Intestinal obstruction: strangulation?

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.