Vascular surgery: IVC filter indication: 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: IVC filter indication

Sample item

A 58-year-old man with acute proximal deep vein thrombosis and pulmonary embolism then develops a major intracranial haemorrhage, making anticoagulation unsafe. What is the appropriate step?

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

The answer and the reasoning

D. Retrievable inferior vena cava filter

An inferior vena cava filter is indicated for acute proximal venous thromboembolism when anticoagulation is absolutely contraindicated, as in active major bleeding. It traps emboli from the legs, and a retrievable device should be removed once anticoagulation can start. Filters do not treat the thrombosis itself.

Option by option

  • A. Warfarin with a high target INR

    Warfarin is an anticoagulant and would aggravate intracranial bleeding.

  • B. Thrombolysis with alteplase

    Thrombolysis markedly increases bleeding and is contraindicated after a haemorrhagic stroke.

  • C. Compression stockings alone

    Stockings do not prevent embolisation from proximal thrombi.

  • D. Retrievable inferior vena cava filter (correct)

    Correct. The filter gives mechanical protection when drugs cannot be given.

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 D, Retrievable inferior vena cava filter. An inferior vena cava filter is indicated for acute proximal venous thromboembolism when anticoagulation is absolutely contraindicated, as in active major bleeding.

Why is "Warfarin with a high target INR" not the answer?

Warfarin is an anticoagulant and would aggravate intracranial bleeding.

Why is "Thrombolysis with alteplase" not the answer?

Thrombolysis markedly increases bleeding and is contraindicated after a haemorrhagic stroke.

Why is "Compression stockings alone" not the answer?

Stockings do not prevent embolisation from proximal thrombi.

What concept does this question test?

It tests Vascular surgery: IVC filter indication in General Surgery. It traps emboli from the legs, and a retrievable device should be removed once anticoagulation can start. Filters do not treat the thrombosis itself.

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: IVC filter indication?

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.