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Vascular ring

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True Vascular Ring MCQ | NEET SS Surgery

True Vascular Ring - NEET SS Surgery MCQ

Q) Which is a true vascular ring?
a) Pulmonary artery sling
b) Double aortic arch
c) Cervical aortic arch
d) Origin of subclavian artery from descending aorta

Correct Answer: b) Double aortic arch

Double aortic arch is a classic example of a true vascular ring. It forms a complete ring around the trachea and esophagus, leading to compressive symptoms such as stridor, wheezing, or feeding difficulties.

Pulmonary artery sling is not a vascular ring. It is a congenital anomaly where the left pulmonary artery arises from the right pulmonary artery and passes between the trachea and esophagus but does not form a complete ring.

Cervical aortic arch is a rare anomaly and does not form a true vascular ring.

Aberrant origin of subclavian artery (e.g., aberrant right subclavian artery from the descending aorta) is considered a partial ring and usually causes less significant symptoms compared to true vascular rings.

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Q . Which of the following has the greatest impact  on the physiology of tetralogy of Fallot?
A. The size of the ASD.
B. The size of the VSD.
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D. The amount of aortic overriding

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B. Tachypnea and failure to thrive are symptoms frequently associated with  large VSDs.
C. Patients with normal pulmonary vascular resistance and left-to-right  shunting across the VSD have Eisenmenger’s complex.
D. Patients with a large VSD and low pulmonary vascular resistance can  present with a mid diastolic murmur at the apex.

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Q Autopsy finding  in a patient who dies of Tetrology of Fallot is

a)  Brachiocephalic vein draining into the left renal vein
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Q) A 68 year old man undergoes repair of infra renal aortic aneurysm. On 2nd POD he has abdominal pain, bloody diarrhea and tachycardia. BP is 120/70. Abdomen is mildly distended and tender especially in the left lower quadrant.

How will you proceed

a) Send stool for clostridium and spores

b) CT Abdomen

c) Exploratory laparotomy

d) Higher antibiotics

Ans b 

Get a contrast CT Abdomen as bowel ischemia is a likely diagnosis 

Incidence of bowel ischemia after repair of aortic aneurysm is around 2-6%. It is because of loss of inferior mesenteric artery artery at the time of surgery and inadequate colonic collaterals. 

Spores and clostridium difficle diarrhea occurs after prolonged antibiotic use. Also there is no bloody diarrhea in it.

Exploratory laparotomy will be required after CT Shows full thickness gangrene and not before

Antibiotic escalation will not help at this stage.