Surgical infections: 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 · Surgical infections

Sample item

A 58-year-old diabetic man has a swollen thigh with dusky skin, bullae, crepitus and pain out of proportion to the findings. He is tachycardic and hypotensive. What is the most appropriate management?

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

The answer and the reasoning

D. Resuscitation, broad-spectrum antibiotics and urgent surgical debridement

These are features of necrotising fasciitis, a rapidly spreading infection of fascia that is a surgical emergency. Mortality rises with delay, so debridement of all necrotic tissue is done together with resuscitation and broad antibiotics covering mixed organisms. Imaging should never delay surgery when the clinical picture is clear.

Option by option

  • A. Hyperbaric oxygen as the sole treatment

    Hyperbaric oxygen is at most an adjunct and cannot replace debridement.

  • B. Oral antibiotics and review after 48 hours

    Oral antibiotics are inadequate for a spreading, toxic infection.

  • C. MRI before deciding on surgery

    Waiting for an MRI delays life-saving surgery.

  • D. Resuscitation, broad-spectrum antibiotics and urgent surgical debridement (correct)

    Correct. Source control by early radical debridement is the key to survival.

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 D, Resuscitation, broad-spectrum antibiotics and urgent surgical debridement. These are features of necrotising fasciitis, a rapidly spreading infection of fascia that is a surgical emergency.

Why is "Hyperbaric oxygen as the sole treatment" not the answer?

Hyperbaric oxygen is at most an adjunct and cannot replace debridement.

Why is "Oral antibiotics and review after 48 hours" not the answer?

Oral antibiotics are inadequate for a spreading, toxic infection.

Why is "MRI before deciding on surgery" not the answer?

Waiting for an MRI delays life-saving surgery.

What concept does this question test?

It tests Surgical infections in General Surgery. Mortality rises with delay, so debridement of all necrotic tissue is done together with resuscitation and broad antibiotics covering mixed organisms. Imaging should never delay surgery when the clinical picture is clear.

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 Surgical infections?

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.