Vascular surgery: inflammatory aortic aneurysm: 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: inflammatory aortic aneurysm

Sample item

A 62-year-old smoker has back pain, weight loss and an ESR of 90 mm/h. CT shows a 5.5 cm infrarenal aortic aneurysm with a markedly thickened enhancing wall, dense periaortic fibrosis sparing the posterior wall, and mild left hydronephrosis. What is the diagnosis?

AIdiopathic retroperitoneal fibrosisBMycotic aortic aneurysmCAortoenteric fistulaDInflammatory abdominal aortic aneurysm

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

The answer and the reasoning

D. Inflammatory abdominal aortic aneurysm

Inflammatory aneurysm has a thickened, glistening wall with dense fibrosis that entraps the duodenum and ureters, and the posterior wall is spared. Patients are usually male smokers with raised inflammatory markers and hydronephrosis. Repair is still indicated, and steroids may reduce fibrosis.

Option by option

A. Idiopathic retroperitoneal fibrosis
Idiopathic retroperitoneal fibrosis encases an aorta of normal calibre and does not usually coexist with a 5.5 cm aneurysm.
B. Mycotic aortic aneurysm
A mycotic aneurysm is infected, usually saccular and eccentric, with fever and positive blood cultures.
C. Aortoenteric fistula
An aortoenteric fistula causes gastrointestinal bleeding in a patient with a previous aortic graft.
D. Inflammatory abdominal aortic aneurysm (correct)
Correct. A thick fibrotic wall with ureteric entrapment and high ESR in an aneurysm indicates the inflammatory type.

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, Inflammatory abdominal aortic aneurysm. Inflammatory aneurysm has a thickened, glistening wall with dense fibrosis that entraps the duodenum and ureters, and the posterior wall is spared.

Why is "Idiopathic retroperitoneal fibrosis" not the answer?

Idiopathic retroperitoneal fibrosis encases an aorta of normal calibre and does not usually coexist with a 5.5 cm aneurysm.

Why is "Mycotic aortic aneurysm" not the answer?

A mycotic aneurysm is infected, usually saccular and eccentric, with fever and positive blood cultures.

Why is "Aortoenteric fistula" not the answer?

An aortoenteric fistula causes gastrointestinal bleeding in a patient with a previous aortic graft.

What concept does this question test?

It tests Vascular surgery: inflammatory aortic aneurysm in General Surgery. Patients are usually male smokers with raised inflammatory markers and hydronephrosis. Repair is still indicated, and steroids may reduce fibrosis.

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: inflammatory aortic aneurysm?

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.