Perioperative care: complications of parenteral nutrition: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Perioperative care: complications of parenteral nutrition

Sample item

A patient on long-term total parenteral nutrition via a central line develops fever and rigors with no other source. What is the most likely cause, and what is the first step?

AAir embolism; hyperbaric oxygenBCholestasis; stop feeds immediatelyCHyperglycaemia; no actionDCatheter-related bloodstream infection; take blood cultures from line and periphery and consider removal

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Catheter-related bloodstream infection; take blood cultures from line and periphery and consider removal

Catheter sepsis is a major TPN complication, with Staphylococcus and Candida the usual organisms. Cultures and line removal if unwell guide treatment. Other complications are hyperglycaemia, refeeding syndrome, cholestasis and fatty liver, and line thrombosis.

Option by option

A. Air embolism; hyperbaric oxygen
Air embolism is acute and does not cause fever and rigors.
B. Cholestasis; stop feeds immediately
Cholestasis is chronic and does not cause rigors.
C. Hyperglycaemia; no action
Hyperglycaemia does not explain rigors.
D. Catheter-related bloodstream infection; take blood cultures from line and periphery and consider removal (correct)
Correct. Suspect line infection with fever and rigors.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Catheter-related bloodstream infection; take blood cultures from line and periphery and consider removal. Catheter sepsis is a major TPN complication, with Staphylococcus and Candida the usual organisms.

Why is "Air embolism; hyperbaric oxygen" not the answer?

Air embolism is acute and does not cause fever and rigors.

Why is "Cholestasis; stop feeds immediately" not the answer?

Cholestasis is chronic and does not cause rigors.

Why is "Hyperglycaemia; no action" not the answer?

Hyperglycaemia does not explain rigors.

What concept does this question test?

It tests Perioperative care: complications of parenteral nutrition in General Surgery. Cultures and line removal if unwell guide treatment. Other complications are hyperglycaemia, refeeding syndrome, cholestasis and fatty liver, and line thrombosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: complications of parenteral nutrition?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.