Vascular surgery: atheroembolism: 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: atheroembolism

Sample item

After cardiac catheterisation, a 70-year-old man has painful bluish toes with palpable pedal pulses, eosinophilia and worsening renal function. What is the mechanism?

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

The answer and the reasoning

B. Cholesterol embolisation from atheromatous plaque

Cholesterol crystals dislodged from aortic plaques lodge in small distal arteries, producing blue toes with palpable pulses, livedo, eosinophilia and renal impairment. Large-vessel occlusion would abolish pulses. Supportive care and stopping anticoagulation are used.

Option by option

  • A. Raynaud vasospasm

    Raynaud phenomenon is episodic and does not cause renal failure.

  • B. Cholesterol embolisation from atheromatous plaque (correct)

    Correct. Showers of cholesterol emboli block small vessels and spare the pulses.

  • C. Heparin-induced thrombocytopenia

    Heparin-induced thrombocytopenia is shown by a falling platelet count and large thrombi.

  • D. Acute thrombosis of the popliteal artery

    Popliteal thrombosis would cause a pulseless cold limb.

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 B, Cholesterol embolisation from atheromatous plaque. Cholesterol crystals dislodged from aortic plaques lodge in small distal arteries, producing blue toes with palpable pulses, livedo, eosinophilia and renal impairment.

Why is "Raynaud vasospasm" not the answer?

Raynaud phenomenon is episodic and does not cause renal failure.

Why is "Heparin-induced thrombocytopenia" not the answer?

Heparin-induced thrombocytopenia is shown by a falling platelet count and large thrombi.

Why is "Acute thrombosis of the popliteal artery" not the answer?

Popliteal thrombosis would cause a pulseless cold limb.

What concept does this question test?

It tests Vascular surgery: atheroembolism in General Surgery. Large-vessel occlusion would abolish pulses. Supportive care and stopping anticoagulation are used.

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: atheroembolism?

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.