Vascular surgery: arteriovenous fistula for dialysis: 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: arteriovenous fistula for dialysis

Sample item

A patient with end-stage renal disease needs permanent haemodialysis access. Which fistula is created first, if vessels are suitable?

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

The answer and the reasoning

C. Radiocephalic (Brescia-Cimino) fistula at the wrist

A radiocephalic fistula at the wrist in the non-dominant arm is preferred first because it preserves proximal sites for later fistulas and has a low steal risk. It requires about six to eight weeks for maturation before cannulation. Tunnelled catheters are a bridge and carry infection risk.

Option by option

  • A. Central venous catheter permanently

    Catheters have higher infection and stenosis rates.

  • B. Brachiobasilic fistula in the dominant arm

    More proximal fistulas are used after distal ones are exhausted.

  • C. Radiocephalic (Brescia-Cimino) fistula at the wrist (correct)

    Correct. This is the first-choice native fistula.

  • D. Femoral artery to femoral vein shunt

    Femoral shunts are not a standard first option.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Radiocephalic (Brescia-Cimino) fistula at the wrist. A radiocephalic fistula at the wrist in the non-dominant arm is preferred first because it preserves proximal sites for later fistulas and has a low steal risk.

Why is "Central venous catheter permanently" not the answer?

Catheters have higher infection and stenosis rates.

Why is "Brachiobasilic fistula in the dominant arm" not the answer?

More proximal fistulas are used after distal ones are exhausted.

Why is "Femoral artery to femoral vein shunt" not the answer?

Femoral shunts are not a standard first option.

What concept does this question test?

It tests Vascular surgery: arteriovenous fistula for dialysis in General Surgery. It requires about six to eight weeks for maturation before cannulation. Tunnelled catheters are a bridge and carry infection risk.

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: arteriovenous fistula for dialysis?

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.