Vascular surgery: complicated type B dissection: 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: complicated type B dissection

Sample item

A 52-year-old man with a Stanford type B aortic dissection has a cold, pulseless left leg and rising creatinine despite blood pressure control. What is the preferred definitive management?

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

The answer and the reasoning

B. Thoracic endovascular aortic repair

Uncomplicated type B dissection is managed medically with impulse control. Complications such as malperfusion of limbs or viscera, rupture, refractory pain or hypertension, or rapid expansion need intervention, and thoracic endovascular aortic repair covers the entry tear and restores true lumen flow. Open surgery is reserved for type A involvement.

Option by option

  • A. Ascending aortic replacement with arch hemiarch

    Ascending replacement is for type A, whereas the tear here lies distal to the left subclavian artery.

  • B. Thoracic endovascular aortic repair (correct)

    Correct. Malperfusion defines a complicated type B dissection that needs stent-graft repair.

  • C. Continued medical therapy alone

    Medical therapy alone is for uncomplicated disease without end-organ ischaemia.

  • D. Bentall procedure

    Bentall repair treats aortic root disease in type A dissection.

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, Thoracic endovascular aortic repair. Uncomplicated type B dissection is managed medically with impulse control.

Why is "Ascending aortic replacement with arch hemiarch" not the answer?

Ascending replacement is for type A, whereas the tear here lies distal to the left subclavian artery.

Why is "Continued medical therapy alone" not the answer?

Medical therapy alone is for uncomplicated disease without end-organ ischaemia.

Why is "Bentall procedure" not the answer?

Bentall repair treats aortic root disease in type A dissection.

What concept does this question test?

It tests Vascular surgery: complicated type B dissection in General Surgery. Complications such as malperfusion of limbs or viscera, rupture, refractory pain or hypertension, or rapid expansion need intervention, and thoracic endovascular aortic repair covers the entry tear and restores true lumen flow. Open surgery is reserved for type A involvement.

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: complicated type B dissection?

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.