Vascular surgery: aortoiliac occlusion: 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: aortoiliac occlusion

Sample item

A 55-year-old male smoker has buttock and thigh claudication and erectile dysfunction. Both femoral pulses are absent and the legs are pale on exertion. What is the most likely diagnosis?

APopliteal artery entrapment syndromeBFemoropopliteal diseaseCLumbar canal stenosisDLeriche syndrome (aortoiliac occlusive disease)

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

The answer and the reasoning

D. Leriche syndrome (aortoiliac occlusive disease)

Leriche syndrome is chronic occlusion of the terminal aorta or both common iliac arteries. It causes the triad of bilateral buttock or thigh claudication, impotence from reduced internal iliac flow, and absent or diminished femoral pulses. Treatment is aortobifemoral bypass or endovascular recanalisation after risk-factor control.

Option by option

A. Popliteal artery entrapment syndrome
Popliteal entrapment causes calf claudication in young active people with normal femoral pulses.
B. Femoropopliteal disease
Femoropopliteal disease causes calf claudication with normal femoral pulses.
C. Lumbar canal stenosis
Neurogenic claudication of canal stenosis has preserved pulses and is relieved by sitting or flexing forward.
D. Leriche syndrome (aortoiliac occlusive disease) (correct)
Correct. The triad of proximal claudication, impotence and absent femoral pulses points to aortoiliac occlusion.

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 D, Leriche syndrome (aortoiliac occlusive disease). Leriche syndrome is chronic occlusion of the terminal aorta or both common iliac arteries.

Why is "Popliteal artery entrapment syndrome" not the answer?

Popliteal entrapment causes calf claudication in young active people with normal femoral pulses.

Why is "Femoropopliteal disease" not the answer?

Femoropopliteal disease causes calf claudication with normal femoral pulses.

Why is "Lumbar canal stenosis" not the answer?

Neurogenic claudication of canal stenosis has preserved pulses and is relieved by sitting or flexing forward.

What concept does this question test?

It tests Vascular surgery: aortoiliac occlusion in General Surgery. It causes the triad of bilateral buttock or thigh claudication, impotence from reduced internal iliac flow, and absent or diminished femoral pulses. Treatment is aortobifemoral bypass or endovascular recanalisation after risk-factor control.

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: aortoiliac occlusion?

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.