Vascular surgery: carotid stenosis: 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: carotid stenosis

Sample item

A 67-year-old man had an episode of transient loss of vision in the right eye lasting 5 minutes, followed by full recovery. Carotid duplex shows 80% stenosis of the right internal carotid artery. What is the best management?

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

The answer and the reasoning

C. Carotid endarterectomy within 2 weeks plus best medical therapy

Symptomatic carotid stenosis of 70 to 99% (NASCET method) benefits from endarterectomy, and the benefit is greatest when surgery is done within 2 weeks of the event because the early stroke risk is high. Amaurosis fugax is a retinal embolic event from the ipsilateral carotid. Medical therapy continues alongside.

Option by option

  • A. Antiplatelets and statin alone

    Medical therapy alone leaves a high early stroke risk when the lesion is surgically correctable.

  • B. Elective endarterectomy after 6 months

    A long delay forfeits the benefit, which is time-dependent.

  • C. Carotid endarterectomy within 2 weeks plus best medical therapy (correct)

    Correct. Early endarterectomy gives the largest stroke risk reduction in symptomatic high-grade stenosis.

  • D. Carotid stenting in all cases, never surgery

    Stenting is an alternative in selected patients and is not the only option.

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 C, Carotid endarterectomy within 2 weeks plus best medical therapy. Symptomatic carotid stenosis of 70 to 99% (NASCET method) benefits from endarterectomy, and the benefit is greatest when surgery is done within 2 weeks of the event because the early stroke risk is high.

Why is "Antiplatelets and statin alone" not the answer?

Medical therapy alone leaves a high early stroke risk when the lesion is surgically correctable.

Why is "Elective endarterectomy after 6 months" not the answer?

A long delay forfeits the benefit, which is time-dependent.

Why is "Carotid stenting in all cases, never surgery" not the answer?

Stenting is an alternative in selected patients and is not the only option.

What concept does this question test?

It tests Vascular surgery: carotid stenosis in General Surgery. Amaurosis fugax is a retinal embolic event from the ipsilateral carotid. Medical therapy continues alongside.

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: carotid stenosis?

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.