Vascular surgery: varicose veins: 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: varicose veins

Sample item

A 40-year-old woman has long saphenous varicose veins. With the leg elevated and emptied, a tourniquet is placed at the saphenofemoral junction. On standing, the veins stay empty for 30 seconds and then fill rapidly once the tourniquet is released. What does this indicate, and what is the usual treatment?

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

The answer and the reasoning

C. Saphenofemoral junction incompetence, treated by endovenous ablation or high ligation with stripping

In the Trendelenburg test, filling after release of the tourniquet (but not while it is applied) shows that reflux is through an incompetent saphenofemoral junction. Treatment is endovenous thermal ablation, foam sclerotherapy or high ligation with stripping, once deep venous patency has been confirmed on duplex scanning. Rapid filling while the tourniquet is on suggests incompetent perforators below it.

Option by option

  • A. Normal valves, with no treatment needed

    The test shows reflux, so the valves are not normal.

  • B. Incompetent perforators in the calf only, treated by compression alone

    Incompetent perforators would cause filling while the tourniquet is still applied.

  • C. Saphenofemoral junction incompetence, treated by endovenous ablation or high ligation with stripping (correct)

    Correct. Delayed filling that is rapid after release localises the reflux to the saphenofemoral junction.

  • D. Deep vein occlusion, treated by saphenous vein ligation

    Deep vein occlusion contraindicates removal of superficial veins, which may be the collateral drainage.

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, Saphenofemoral junction incompetence, treated by endovenous ablation or high ligation with stripping. In the Trendelenburg test, filling after release of the tourniquet (but not while it is applied) shows that reflux is through an incompetent saphenofemoral junction.

Why is "Normal valves, with no treatment needed" not the answer?

The test shows reflux, so the valves are not normal.

Why is "Incompetent perforators in the calf only, treated by compression alone" not the answer?

Incompetent perforators would cause filling while the tourniquet is still applied.

Why is "Deep vein occlusion, treated by saphenous vein ligation" not the answer?

Deep vein occlusion contraindicates removal of superficial veins, which may be the collateral drainage.

What concept does this question test?

It tests Vascular surgery: varicose veins in General Surgery. Treatment is endovenous thermal ablation, foam sclerotherapy or high ligation with stripping, once deep venous patency has been confirmed on duplex scanning. Rapid filling while the tourniquet is on suggests incompetent perforators below it.

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: varicose veins?

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.