Free JCIE Intercollegiate Specialty Examination in Vascular Surgery — Section 1 Practice Questions

Sample Practice Questions

Try these 10 sample questions from the JCIE Intercollegiate Specialty Examination in Vascular Surgery — Section 1 practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1During distal bypass planning, a surgeon follows the dorsalis pedis artery proximally across the ankle. In usual anatomy, which artery continues into it?

   1. A.Anterior tibial arteryCorrect answer: A
   2. B.Posterior tibial artery
   3. C.Fibular artery
   4. D.Popliteal artery

   Explanation: The source states: "Upon reaching the tarsal region, it becomes the dorsalis pedis artery". The antecedent is the anterior tibial artery. Posterior tibial supplies the plantar circulation; fibular supplies the lateral leg; popliteal divides higher in the leg.

   Reference: OpenStax Anatomy and Physiology: Circulatory Pathways — 20.5, Arteries Serving the Lower Limbs

2. 2In England, a vascular surgeon refers a patient for CT angiography under IR(ME)R. Which duty holder is responsible for justifying the individual medical exposure?

   1. A.The entitled referrer
   2. B.The entitled operator
   3. C.The medical physics expert
   4. D.The IR(ME)R practitionerCorrect answer: D

   Explanation: The source states: "The practitioner is responsible for the justification of each individual exposure.". Justification is the practitioner's duty. Referrers supply clinical information, operators undertake practical aspects and medical physics experts advise on radiation physics.

   Reference: DHSC Guidance to the Ionising Radiation (Medical Exposure) Regulations 2017 — Regulation 11(1)(b)

3. 3For a femoropopliteal bypass, the surgeon plans an autologous conduit from the principal superficial vein running along the medial leg from ankle to groin. Which vein is intended?

   1. A.Small saphenous vein
   2. B.Anterior tibial vein
   3. C.Great saphenous veinCorrect answer: C
   4. D.Popliteal vein

   Explanation: The source states: "It is called the long saphenous vein". The long or great saphenous vein is the described superficial medial conduit. Small saphenous follows a different course; anterior tibial and popliteal veins are deep veins.

   Reference: Circulation Foundation: Femoral Popliteal and Femoral Distal Bypass — The operation, conduit selection

4. 4During peripheral angioplasty, plaque fragments become dislodged and travel farther down the leg, producing a new distal occlusion. Which complication has occurred?

   1. A.Distal embolisationCorrect answer: A
   2. B.Arterial dissection
   3. C.Elastic recoil
   4. D.Intimal hyperplasia

   Explanation: The source states: "cause another blockage (distal embolisation)". The transported fragments create an embolus downstream. Dissection separates wall layers; recoil is immediate narrowing at the treated segment; intimal hyperplasia is tissue growth rather than transported fragments.

   Reference: Worcestershire Acute Hospitals: Angioplasty and Stenting — Risks of angioplasty, distal embolisation

5. 5In an NHS Highland hospital, a patient has acute limb ischaemia and no active bleeding or other contraindication to anticoagulation. Which immediate intravenous antithrombotic treatment is specified while emergency intervention is arranged?

   1. A.Alteplase
   2. B.Bivalirudin
   3. C.HeparinCorrect answer: C
   4. D.Epoprostenol

   Explanation: The source states: "IV heparin". The uncomplicated initial acute pathway specifies intravenous heparin. Alteplase is fibrinolytic treatment, bivalirudin is an alternative anticoagulant in selected circumstances, and epoprostenol is a prostacyclin; none is this pathway's standard initial IV agent.

   Reference: NHS Highland: Vascular Guidelines — Acute limb ischaemia, Secondary Care input

6. 6A patient with recurrent abdominal-wall abscesses has a bacterial isolate producing Panton–Valentine leukocidin. Which organism is associated with this toxin?

   1. A.Streptococcus pyogenes
   2. B.Staphylococcus aureusCorrect answer: B
   3. C.Pseudomonas aeruginosa
   4. D.Clostridium perfringens

   Explanation: The source states: "Panton-Valentine leukocidin (PVL) is a cytotoxin produced by some strains of Staphylococcus aureus that causes leukocyte destruction and tissue necrosis.". PVL-producing S. aureus can cause recurrent skin and soft-tissue abscesses; the other organisms can cause wound infections but are not the organism identified by this toxin.

   Reference: NHS Scotland National Infection Prevention and Control Manual: A–Z pathogens — Panton Valentine Leukocidin (PVL) positive Staphylococcus aureus

7. 7During aortic exposure, a surgeon identifies the left gonadal vein. In usual anatomy, into which vessel does it drain?

   1. A.Inferior vena cava
   2. B.Left renal veinCorrect answer: B
   3. C.Left common iliac vein
   4. D.Splenic vein

   Explanation: The source states: "the left gonadal vein empties into the left renal vein". Left gonadal drainage enters the renal vein. Right gonadal drainage usually enters the cava; iliac and splenic veins are different pathways.

   Reference: OpenStax Anatomy and Physiology: Circulatory Pathways — 20.5, Veins of the Abdominal Region

8. 8For a vascular CT examination in England, exposure settings are adjusted to keep dose as low as reasonably practicable while preserving the intended diagnostic purpose. Which IR(ME)R principle is being applied?

   1. A.Justification
   2. B.Clinical audit
   3. C.OptimisationCorrect answer: C
   4. D.Quality assurance

   Explanation: The source requires dose to be "as low as reasonably practicable, but consistent with the intended purpose". This is optimisation. Justification assesses net benefit, clinical audit compares practice with standards, and quality assurance provides systematic checks on quality.

   Reference: DHSC Guidance to the Ionising Radiation (Medical Exposure) Regulations 2017 — Regulation 12, optimisation

9. 9A patient's artificial lower-limb bypass graft has a confirmed graft infection. In counselling about the usual surgical treatment described in the vascular leaflet, which intervention should the surgeon discuss?

   1. A.Balloon dilatation of the graft
   2. B.Thrombectomy of the graft
   3. C.Catheter-directed thrombolysis of the graft
   4. D.Removal of the infected graftCorrect answer: D

   Explanation: The source states: "usually treatment involves removal of the graft". The leaflet distinguishes serious graft infection from superficial wound infection and says removal is usually involved. Dilatation, thrombectomy and thrombolysis do not treat the infected implanted material itself.

   Reference: Circulation Foundation: Femoral Popliteal and Femoral Distal Bypass — Complications, Graft infection

10. 10During image-guided glue embolisation of a varix, what is the intended immediate effect within the treated vessel?

    1. A.Restore patency by enlarging its lumen
    2. B.Occlude flow by creating an intraluminal blockageCorrect answer: B
    3. C.Support patency by deploying an open scaffold
    4. D.Restore patency by dissolving existing thrombus

    Explanation: The source states: "causes a blockage of blood flow as the glue sets inside the vein". Glue embolisation intentionally occludes the target varix. Dilatation, open scaffolding and thrombolysis aim to maintain or restore patency, a different endovascular objective.

    Reference: Leeds Teaching Hospitals: Embolisation of Varices — How embolisation is performed