Preoperative assessment: GLP-1 agonist and aspiration: practice question

A Anaesthesia 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.

Try it

Anaesthesia · Preoperative assessment: GLP-1 agonist and aspiration

Sample item

A 52-year-old woman with type 2 diabetes takes weekly semaglutide. On the morning of elective surgery she reports nausea and abdominal bloating, although she has fasted for 8 hours. What is the most appropriate anaesthetic approach?

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

The answer and the reasoning

A. Treat as a full stomach: check gastric contents by ultrasound if available, or proceed with rapid sequence induction

GLP-1 receptor agonists slow gastric emptying, so residual gastric contents can persist despite standard fasting, especially when symptoms such as nausea and bloating are present. Gastric ultrasound or a full-stomach technique with rapid sequence induction lowers the aspiration risk. Fasting time alone is not reassuring in this setting.

Option by option

  • A. Treat as a full stomach: check gastric contents by ultrasound if available, or proceed with rapid sequence induction (correct)

    Correct. Symptoms on a GLP-1 agonist suggest retained gastric contents, so the airway should be protected.

  • B. Give IV glycopyrrolate to empty the stomach before induction

    Glycopyrrolate reduces secretions and has no useful effect on gastric emptying.

  • C. Proceed with routine induction and a supraglottic airway because the fasting time was adequate

    A fixed fasting time does not exclude retained contents when gastric emptying is delayed.

  • D. Give a double dose of sodium citrate and then use a standard induction

    Sodium citrate neutralises acid but does not remove the volume of gastric contents.

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.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Treat as a full stomach: check gastric contents by ultrasound if available, or proceed with rapid sequence induction. GLP-1 receptor agonists slow gastric emptying, so residual gastric contents can persist despite standard fasting, especially when symptoms such as nausea and bloating are present.

Why is "Give IV glycopyrrolate to empty the stomach before induction" not the answer?

Glycopyrrolate reduces secretions and has no useful effect on gastric emptying.

Why is "Proceed with routine induction and a supraglottic airway because the…" not the answer?

A fixed fasting time does not exclude retained contents when gastric emptying is delayed.

Why is "Give a double dose of sodium citrate and then use a standard induction" not the answer?

Sodium citrate neutralises acid but does not remove the volume of gastric contents.

What concept does this question test?

It tests Preoperative assessment: GLP-1 agonist and aspiration in Anaesthesia. Gastric ultrasound or a full-stomach technique with rapid sequence induction lowers the aspiration risk. Fasting time alone is not reassuring in this setting.

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 Preoperative assessment: GLP-1 agonist and aspiration?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.