Vascular surgery: management of chronic lymphoedema: 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: management of chronic lymphoedema

Sample item

A woman has chronic non-pitting lymphoedema of the left leg after pelvic radiotherapy, with recurrent cellulitis. Which is the mainstay of conservative management?

ALong-term loop diuretics to reduce limb volumeBProphylactic anticoagulation with warfarinCRadical excision of subcutaneous tissue as the first treatmentDCompression garments with skin care, exercise and manual lymph drainage

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

The answer and the reasoning

D. Compression garments with skin care, exercise and manual lymph drainage

Complex decongestive therapy combines compression, skin hygiene, exercise and manual lymph drainage. Diuretics remove water but not protein-rich lymph, and excisional operations are kept for selected severe cases. Prompt antibiotics for cellulitis protect remaining lymphatics.

Option by option

A. Long-term loop diuretics to reduce limb volume
Diuretics are ineffective for lymphoedema because the fluid is protein-rich and not simply excess water.
B. Prophylactic anticoagulation with warfarin
Lymphoedema is not a thrombotic disorder, so anticoagulation has no role.
C. Radical excision of subcutaneous tissue as the first treatment
Excisional procedures carry poor results and are reserved for refractory massive limbs, not first-line care.
D. Compression garments with skin care, exercise and manual lymph drainage (correct)
Correct. Compression with skin care, exercise and lymph drainage is the standard conservative approach.

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, Compression garments with skin care, exercise and manual lymph drainage. Complex decongestive therapy combines compression, skin hygiene, exercise and manual lymph drainage.

Why is "Long-term loop diuretics to reduce limb volume" not the answer?

Diuretics are ineffective for lymphoedema because the fluid is protein-rich and not simply excess water.

Why is "Prophylactic anticoagulation with warfarin" not the answer?

Lymphoedema is not a thrombotic disorder, so anticoagulation has no role.

Why is "Radical excision of subcutaneous tissue as the first treatment" not the answer?

Excisional procedures carry poor results and are reserved for refractory massive limbs, not first-line care.

What concept does this question test?

It tests Vascular surgery: management of chronic lymphoedema in General Surgery. Diuretics remove water but not protein-rich lymph, and excisional operations are kept for selected severe cases. Prompt antibiotics for cellulitis protect remaining lymphatics.

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: management of chronic lymphoedema?

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.