Vascular surgery: Takayasu arteritis: 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: Takayasu arteritis

Sample item

A 24-year-old woman has fatigue, arm claudication and low-grade fever for 2 months. The left radial pulse is absent, the arm blood pressures differ by 40 mmHg, there is a subclavian bruit, and ESR is 70 mm/h. What is the appropriate initial treatment of her active disease?

AHigh-dose glucocorticoids, with revascularisation deferred until quiescenceBImmediate subclavian bypassCLong-term antibioticsDAnticoagulation alone

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

The answer and the reasoning

A. High-dose glucocorticoids, with revascularisation deferred until quiescence

Takayasu arteritis is a granulomatous large-vessel vasculitis of the aorta and its branches, seen mainly in young women and common in India. During the active inflammatory phase glucocorticoids, with added immunosuppressants for relapse, control inflammation. Surgery or stenting done during active disease has poor outcomes, so revascularisation is performed once the disease is quiescent.

Option by option

A. High-dose glucocorticoids, with revascularisation deferred until quiescence (correct)
Correct. Suppressing inflammation comes first and intervention follows in remission.
B. Immediate subclavian bypass
Surgery during active inflammation leads to anastomotic complications and restenosis.
C. Long-term antibiotics
The process is autoimmune rather than infective, so antibiotics do not help.
D. Anticoagulation alone
Anticoagulation does not treat arteritic stenoses.

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, High-dose glucocorticoids, with revascularisation deferred until quiescence. Takayasu arteritis is a granulomatous large-vessel vasculitis of the aorta and its branches, seen mainly in young women and common in India.

Why is "Immediate subclavian bypass" not the answer?

Surgery during active inflammation leads to anastomotic complications and restenosis.

Why is "Long-term antibiotics" not the answer?

The process is autoimmune rather than infective, so antibiotics do not help.

Why is "Anticoagulation alone" not the answer?

Anticoagulation does not treat arteritic stenoses.

What concept does this question test?

It tests Vascular surgery: Takayasu arteritis in General Surgery. During the active inflammatory phase glucocorticoids, with added immunosuppressants for relapse, control inflammation. Surgery or stenting done during active disease has poor outcomes, so revascularisation is performed once the disease is quiescent.

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: Takayasu arteritis?

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.