Infectious diseases: necrotising fasciitis: 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.

Try it

General Medicine · Infectious diseases: necrotising fasciitis

Sample item

A 55-year-old diabetic man has a rapidly spreading red, swollen leg with severe pain out of proportion to the visible changes. He is hypotensive and a few areas of skin are dusky with bullae. What is the most important next step?

AMRI of the leg before any interventionBOral antibiotics and review after 48 hoursCUrgent surgical exploration and debridement with broad-spectrum antibioticsDCompression bandaging and elevation

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

The answer and the reasoning

C. Urgent surgical exploration and debridement with broad-spectrum antibiotics

Pain out of proportion, rapid spread, bullae and shock suggest necrotising fasciitis. Survival depends on early surgery to remove infected tissue, together with broad-spectrum antibiotics covering anaerobes, streptococci and Gram-negative organisms.

Option by option

A. MRI of the leg before any intervention
Imaging delays surgery in a clinically obvious case.
B. Oral antibiotics and review after 48 hours
Oral antibiotics with a delayed review would allow a lethal infection to spread.
C. Urgent surgical exploration and debridement with broad-spectrum antibiotics (correct)
Correct. Early debridement is the definitive and life-saving step.
D. Compression bandaging and elevation
Compression and elevation treat venous or lymphatic oedema, not this infection.

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 C, Urgent surgical exploration and debridement with broad-spectrum antibiotics. Pain out of proportion, rapid spread, bullae and shock suggest necrotising fasciitis.

Why is "MRI of the leg before any intervention" not the answer?

Imaging delays surgery in a clinically obvious case.

Why is "Oral antibiotics and review after 48 hours" not the answer?

Oral antibiotics with a delayed review would allow a lethal infection to spread.

Why is "Compression bandaging and elevation" not the answer?

Compression and elevation treat venous or lymphatic oedema, not this infection.

What concept does this question test?

It tests Infectious diseases: necrotising fasciitis in General Medicine. Survival depends on early surgery to remove infected tissue, together with broad-spectrum antibiotics covering anaerobes, streptococci and Gram-negative organisms.

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 Infectious diseases: necrotising fasciitis?

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.