Vascular Surgery Practice Questions

Q: A patient complains of leg pain along with cramps and pruritus. On physical examination, visible limb veins are noticed. For further evaluation a test is conducted which is shown in the image. All are the possible sites for performing this test except:

Below the ankle. ***Below the ankle*** - The **Trendelenburg test (Perth test)** is used to assess venous valvular incompetence in the lower limb, specifically in the great saphenous vein and its tributaries. - The test involves the use of a **tourniquet** to occlude blood flow, and the primary purpose is to identify points of venous reflux, which are typically found **above the ankle**, along the course of the saphenous veins and perforators. - Applying a tourniquet **below the ankle** would not be useful for assessing saphenous vein competence, as the major superficial veins being tested lie above this level. *Saphenofemoral junction* - The saphenofemoral junction is a key site for incompetence in **varicose veins**, and the Trendelenburg test is designed to assess reflux at this junction. - Applying pressure or a tourniquet just below this junction helps differentiate between incompetence at the junction and incompetence of distal perforators. *Above the knee level* - The Trendelenburg test commonly involves applying a **tourniquet above the knee** to isolate the saphenofemoral junction and assess for reflux. - This position helps in determining whether the incompetence is primarily at the saphenofemoral junction or involves the perforating veins in the thigh. *Mid-thigh level* - A tourniquet can be applied at the **mid-thigh level** to evaluate the competence of perforating veins in the thigh region. - This helps localize the level of venous incompetence and determine whether multiple segments of the saphenous system are affected. *Below the knee level* - A tourniquet is also applied **below the knee** during the Trendelenburg test to evaluate competence of the perforating veins in the calf. - This helps differentiate between deep vein incompetence and superficial vein incompetence due to perforator issues.

Q: Which is the most common site of peripheral aneurysm?

B. ***Option B*** - This image points to the **popliteal artery**, which is the most common site for **peripheral aneurysms**. - **Popliteal artery aneurysms** account for approximately 70% of all peripheral aneurysms and are more common in men. *Option A* - This image points to the **brachial artery** in the upper arm, which is a less common site for aneurysms. - While aneurysms can occur here, they are not as frequent as in the popliteal artery. *Option C* - This image points to the **femoral artery** in the groin region. - Although the femoral artery can be affected by aneurysms, they are less common than popliteal artery aneurysms. *Option D* - This image points to the **tibial arteries** in the lower leg. - Aneurysms in the tibial arteries are rare and typically much less common than those in the popliteal artery. *Option E* - This image points to the **radial artery** in the forearm. - Radial artery aneurysms are very rare and usually occur secondary to trauma or iatrogenic injury, not spontaneously like popliteal aneurysms.

Question 1

A patient complains of leg pain along with cramps and pruritus. On physical examination, visible limb veins are noticed. For further evaluation a test is conducted which is shown in the image. All are the possible sites for performing this test except:

Accepted Answer

Below the ankle

Answer

Saphenofemoral junction

Answer

Above the knee level

Answer

Below the knee level

Answer

Mid-thigh level

Question 2

Identify the ulcer types shown in images A and B.

Accepted Answer

A=Venous ulcer and B=Ischemic ulcer

Answer

A=Arterial ulcer and B=Venous ulcer

Answer

A=Neuropathic ulcer and B=Arterial ulcer

Answer

A=Venous ulcer and B=Neuropathic ulcer

Answer

A=Arterial ulcer and B=Arterial ulcer

Question 3

Which is the most common site of peripheral aneurysm?

Accepted Answer

B

Answer

A

Answer

C

Answer

D

Answer

E

Question 4

A patient has developed a disease shown below after receiving neck irradiation. Which is the best management for the patient?

Accepted Answer

Carotid endarterectomy

Answer

Low dose Aspirin

Answer

Carotid angioplasty and stenting

Answer

Carotid bypass procedure

Answer

Anticoagulation therapy

Vascular Surgery — MCQs

Vascular Surgery — MCQs

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