NEET SS 2024 DrNB Vascular Surgery Paper2 Question Paper Available - Download Here with Solution PDF

A 48-year-old male was started on anticoagulation for unprovoked deep vein thrombosis (common femoral vein and popliteal vein) with pulmonary embolism. He has following doubts after reading about DVT on internet and needs a counselling session with the treating vascular surgeon:

(a) How long should he continue on anticoagulation?

(b)What are the precautions while taking anticoagulation?

(c)What are the chances of developing a malignancy and why?

(d)Why was he not given the benefit of thrombolysis?

A 58-year-old male chronic smoker diabetic and having normal coronaries presents with bilateral calf claudication. Femoral pulses are palpable but distal pulses are absent with bilateral ABI of 0.5 and no rest pain or tissue loss. He has following doubts after reading about peripheral vascular disease on internet and needs a counselling session with the treating vascular surgeon.

(a) Whether he should get operated / intervened or not?

(b)What are the chances of losing the limb over the next few years & what are the chances of mortality?

(c)What are the components of best medical management you would advise to him?

A 65-year-old male presented with history of TIA, transient right upper limb weakness, diagnosed to have bilateral carotid artery stenosis on colour doppler.

(a) How would you evaluate this patient?

(b)How would you assess the plaque morphology?

(c)How would you manage him?

A 65-year-old patient presented with chest pain with ECG changes. However, his transthoracic ECHO was normal and coronary arteries were normal on coronary angiography done through right radial artery. There was suspicion of aortic dissection while carrying out coronary angiography.

(a) What is the likely diagnosis?

(b)How will you evaluate him further?

(c)How will you manage him?

A 55-year-old male underwent a common femoral artery to below knee popliteal artery bypass using reversed great saphenous vein graft one month ago.

(a) How will you follow him up?

(b)After 6 months, PSV were found to be increased on distal anastomotic site on colour doppler. What is the likely etiology at this juncture? How will you proceed further?

(c)How are the lesions in the venous grafts categorised based on PSV and velocity ratios (Vr)?

Type 3 Crawford aneurysm:

(a) Advantages and disadvantages of open surgical repair vs total endovascular repair.

(b)Mechanisms to prevent spinal cord ischemia.

A 65-year-old male, presented with acute onset pain in right lower limb, with absent popliteal and below pulses. On admission, patient had ongoing pain and was having venous signals in foot with mild to moderate sensorimotor deficit.

(a) What is your diagnosis? Classify the different types of presentation.

(b)He developed a painful calf after one hour of the procedure. What is the condition and how will you manage it?

A 68-year-old male with chronic kidney disease underwent left brachiocephalic arteriovenous fistula 8 months back and is well functional. He complains of a feeling of coldness in left hand while undergoing dialysis for the past two months:

(a) What is the condition he is suffering from?

(b)What are the various grades of this condition?

(c)How will you manage him now and if this condition progresses?

A patient underwent thrombectomy of femoro popliteal segment with poor outflow and was on heparin infusion. His platelet count dropped from 2 lakhs to 1 lakh/mm\(^3\) on 6th day of infusion. Other blood parameters were normal and there was no feature of sepsis/infection.

(a) What is the likely cause of this condition?

(b)How will you confirm your diagnosis?

(c)What is the pathology behind the process?

(d)How will you manage this condition?

Describe mechanism of action, indications, dosage, and side effects of the following drugs:

(a) Cilostazol.

(b)Rivaroxaban.