Vascular surgery: ABPI interpretation: 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: ABPI interpretation

Sample item

A 68-year-old man with diabetes and chronic kidney disease has a foot ulcer. The brachial systolic pressure is 100 mmHg and the ankle pressure cannot be compressed until 150 mmHg, giving an ankle-brachial index of 1.5. What is the best next step?

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

The answer and the reasoning

A. Measure toe pressures and toe-brachial index

The index is 150 divided by 100, which is 1.5. A value above 1.3 indicates calcified, non-compressible tibial vessels, common in diabetes and renal failure, so it cannot be trusted to exclude ischaemia. Digital arteries are rarely calcified, so toe pressure or toe-brachial index, with Doppler waveforms or duplex, gives a reliable assessment.

Option by option

  • A. Measure toe pressures and toe-brachial index (correct)

    Correct. Toe pressures bypass the calcified vessels and assess true perfusion.

  • B. Conclude the arterial supply is normal

    A raised value signals falsely high readings and does not mean normal flow.

  • C. Proceed to below-knee amputation

    Amputation is premature before vascular assessment and revascularisation options.

  • D. Start compression bandaging

    Compression is dangerous if arterial insufficiency has not been excluded.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Measure toe pressures and toe-brachial index. The index is 150 divided by 100, which is 1.

Why is "Conclude the arterial supply is normal" not the answer?

A raised value signals falsely high readings and does not mean normal flow.

Why is "Proceed to below-knee amputation" not the answer?

Amputation is premature before vascular assessment and revascularisation options.

Why is "Start compression bandaging" not the answer?

Compression is dangerous if arterial insufficiency has not been excluded.

What concept does this question test?

It tests Vascular surgery: ABPI interpretation in General Surgery. 5. A value above 1.3 indicates calcified, non-compressible tibial vessels, common in diabetes and renal failure, so it cannot be trusted to exclude ischaemia. Digital arteries are rarely calcified, so toe pressure or toe-brachial index, with Doppler waveforms or duplex, gives a reliable assessment.

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: ABPI interpretation?

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.