Vascular surgery: 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

Sample item

A 70-year-old man with atrial fibrillation has sudden severe pain, pallor, coldness and absent pulses in the left leg for three hours. What is the immediate management?

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

The answer and the reasoning

C. Intravenous unfractionated heparin

A sudden painful pale pulseless cold limb in a patient with atrial fibrillation is acute limb ischaemia from an embolus. Immediate systemic heparin limits clot propagation while the limb is assessed, and urgent embolectomy or thrombolysis follows, since irreversible damage can occur within hours.

Option by option

  • A. Application of heat to the limb

    Heat increases metabolic demand of ischaemic tissue and can cause burns in an insensate limb.

  • B. Oral warfarin alone and review

    Warfarin takes days to act and cannot treat an acute occlusion.

  • C. Intravenous unfractionated heparin (correct)

    Correct. Prompt heparin prevents extension of thrombus and protects the collateral circulation.

  • D. Elective arterial bypass in a few weeks

    Elective bypass is far too late for a limb that may be lost within hours.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Intravenous unfractionated heparin. A sudden painful pale pulseless cold limb in a patient with atrial fibrillation is acute limb ischaemia from an embolus.

Why is "Application of heat to the limb" not the answer?

Heat increases metabolic demand of ischaemic tissue and can cause burns in an insensate limb.

Why is "Oral warfarin alone and review" not the answer?

Warfarin takes days to act and cannot treat an acute occlusion.

Why is "Elective arterial bypass in a few weeks" not the answer?

Elective bypass is far too late for a limb that may be lost within hours.

What concept does this question test?

It tests Vascular surgery in General Surgery. Immediate systemic heparin limits clot propagation while the limb is assessed, and urgent embolectomy or thrombolysis follows, since irreversible damage can occur within hours.

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?

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.