Vascular Surgery Practice Questions

Q: Identify the instrument in the image:

Gillies forceps. ***Gillies forceps*** - This instrument is characterized by its **long, slender design** and **ratcheted handle**, as well as the presence of a **single tooth** at the tip on one jaw and a corresponding groove on the other, which helps in grasping delicate tissues firmly. - They are primarily used in plastic and reconstructive surgery for **handling skin and delicate tissues** without crushing them, often used for skin grafting or closure. *Adson forceps* - Adson forceps are typically **shorter** and have **fine, serrated, or toothed tips**, designed for handling delicate tissues in a variety of surgical specialties. - They are available in different forms such as **Adson with teeth** (for skin and fascia) and **Adson without teeth** (for delicate tissues). *Spencer Wells forceps* - Spencer Wells forceps are a type of **hemostatic forceps** used for clamping blood vessels to control bleeding. - They have **serrated jaws that lock** and are designed to securely grasp and occlude vessels. *DeBakey forceps* - DeBakey forceps are characterized by their **long, narrow shafts** and **atraumatic, finely serrated tips** designed to minimize tissue damage. - They are most commonly used in **vascular surgery** for grasping delicate vessels and tissues without crushing them. *Allis forceps* - Allis forceps have **multiple interlocking teeth** on both jaws, creating a more secure but potentially more traumatic grip. - They are commonly used for **grasping thick tissues** such as fascia, bowel, or tissue during abdominal surgery, but are **not ideal for delicate skin work**.

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.

Question 1

A 3-year-old boy is brought to the emergency department by his parents with a 12-hour history of intermittent, severe crampy abdominal pain that occurs in episodes lasting 2–3 minutes followed by periods during which the child appears completely well. He has had two episodes of vomiting and passed one stool described as 'red currant jelly.' On examination, his abdomen is soft between episodes with a sausage-shaped mass palpable in the right upper quadrant. An abdominal ultrasound is obtained and shows a target sign (concentric rings) in the right upper quadrant consistent with ileocolic intussusception. Which of the following is the most appropriate next step in management?

Accepted Answer

Attempt pneumatic or hydrostatic enema reduction under fluoroscopic or ultrasound guidance

Answer

Perform urgent exploratory laparotomy for manual reduction and possible bowel resection

Answer

Administer IV morphine and bowel rest with nasogastric decompression and reassess in 6 hours

Answer

Obtain a technetium-99m pertechnetate scan to evaluate for a Meckel's diverticulum

Answer

Administer IV antibiotics and schedule semi-elective surgical exploration within 24 hours

Question 2

Identify the instrument in the image:

Accepted Answer

Gillies forceps

Answer

Adson forceps

Answer

Spencer Wells forceps

Answer

DeBakey forceps

Answer

Allis forceps

Question 3

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 4

Comment on image $A$ 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 = Neuropathic ulcer and B = Venous ulcer

Question 5

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

Vascular Surgery — MCQs

Vascular Surgery — MCQs

On this page

Practice by Chapter

Want unlimited practice?