Vascular surgery: popliteal artery entrapment: 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: popliteal artery entrapment

Sample item

A 24-year-old marathon runner has calf cramps after a few kilometres. His foot pulses are normal at rest but the pedal pulses disappear when he actively plantar-flexes against resistance. What is the most likely diagnosis?

AAtherosclerotic occlusion of the superficial femoral arteryBThromboangiitis obliteransCPopliteal artery entrapment syndromeDChronic exertional compartment syndrome

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

The answer and the reasoning

C. Popliteal artery entrapment syndrome

In popliteal entrapment an abnormal relationship between the artery and the medial head of gastrocnemius or a fibrous band compresses the vessel during muscle contraction. Young athletes present with exertional calf claudication and pulses that vanish on plantar flexion or dorsiflexion. Duplex with provocative manoeuvres or MR angiography confirms it.

Option by option

A. Atherosclerotic occlusion of the superficial femoral artery
Atherosclerosis is unlikely at this age and would give fixed pulse loss rather than provoked loss.
B. Thromboangiitis obliterans
Thromboangiitis obliterans affects smokers with distal ischaemia and does not cause pulse loss on movement.
C. Popliteal artery entrapment syndrome (correct)
Correct. The artery is compressed by the surrounding muscle or band when the calf contracts, abolishing pulses.
D. Chronic exertional compartment syndrome
Exertional compartment syndrome causes tight painful calves but pulses stay normal during provocation.

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 C, Popliteal artery entrapment syndrome. In popliteal entrapment an abnormal relationship between the artery and the medial head of gastrocnemius or a fibrous band compresses the vessel during muscle contraction.

Why is "Atherosclerotic occlusion of the superficial femoral artery" not the answer?

Atherosclerosis is unlikely at this age and would give fixed pulse loss rather than provoked loss.

Why is "Thromboangiitis obliterans" not the answer?

Thromboangiitis obliterans affects smokers with distal ischaemia and does not cause pulse loss on movement.

Why is "Chronic exertional compartment syndrome" not the answer?

Exertional compartment syndrome causes tight painful calves but pulses stay normal during provocation.

What concept does this question test?

It tests Vascular surgery: popliteal artery entrapment in General Surgery. Young athletes present with exertional calf claudication and pulses that vanish on plantar flexion or dorsiflexion. Duplex with provocative manoeuvres or MR angiography confirms it.

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: popliteal artery entrapment?

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.