Rheumatology: Buerger disease management: practice question

A General Medicine 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 Medicine · Rheumatology: Buerger disease management

Sample item

A 32-year-old man who smokes bidis heavily has painful ulcers on his fingertips, rest pain in the feet and a history of migratory superficial thrombophlebitis. Cholesterol and ESR are normal, and angiography shows corkscrew collaterals. Which intervention is the most important in treatment?

ALifelong warfarin therapyBLong-term systemic corticosteroidsCBypass grafting of all affected vesselsDComplete cessation of tobacco use

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

The answer and the reasoning

D. Complete cessation of tobacco use

Thromboangiitis obliterans is a segmental inflammatory occlusive disease of small and medium vessels strongly linked to tobacco. Stopping all tobacco use is the only measure that halts progression and prevents amputation. Drugs and surgery have limited benefit if smoking continues.

Option by option

A. Lifelong warfarin therapy
Anticoagulation has no proven benefit.
B. Long-term systemic corticosteroids
Steroids do not alter the course of this disease.
C. Bypass grafting of all affected vessels
Bypass is often not possible because of distal disease, and it fails if the patient continues to smoke.
D. Complete cessation of tobacco use (correct)
Correct. Disease activity depends on tobacco exposure, and abstinence halts progression.

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 Medicine question

What is the answer to this General Medicine question?

The best answer is D, Complete cessation of tobacco use. Thromboangiitis obliterans is a segmental inflammatory occlusive disease of small and medium vessels strongly linked to tobacco.

Why is "Lifelong warfarin therapy" not the answer?

Anticoagulation has no proven benefit.

Why is "Long-term systemic corticosteroids" not the answer?

Steroids do not alter the course of this disease.

Why is "Bypass grafting of all affected vessels" not the answer?

Bypass is often not possible because of distal disease, and it fails if the patient continues to smoke.

What concept does this question test?

It tests Rheumatology: Buerger disease management in General Medicine. Stopping all tobacco use is the only measure that halts progression and prevents amputation. Drugs and surgery have limited benefit if smoking continues.

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 Rheumatology: Buerger disease management?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.