Preoperative assessment: hypertension: 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.

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Anaesthesia · Preoperative assessment: hypertension

Sample item

A patient on amlodipine has a clinic BP of 165/100 mmHg and is due for elective surgery with no end-organ damage. What is the usual approach?

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

The answer and the reasoning

A. Proceed with surgery and continue the antihypertensive

Elective surgery usually proceeds when pressure is below 180/110 mmHg and no end-organ damage is present. Antihypertensives are continued perioperatively, with ACE inhibitors and ARBs being the common exception. Severe hypertension at or above this level warrants optimisation.

Option by option

  • A. Proceed with surgery and continue the antihypertensive (correct)

    Correct. Moderate hypertension without organ damage does not delay surgery.

  • B. Cancel all surgery until BP is below 120/80 mmHg

    A target of 120/80 is not required before elective surgery.

  • C. Stop amlodipine on the day of surgery

    Stopping a calcium channel blocker can cause rebound hypertension.

  • D. Give a large dose of a beta blocker preoperatively

    A large single beta blocker dose may cause hypotension and bradycardia.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Proceed with surgery and continue the antihypertensive. Elective surgery usually proceeds when pressure is below 180/110 mmHg and no end-organ damage is present.

Why is "Cancel all surgery until BP is below 120/80 mmHg" not the answer?

A target of 120/80 is not required before elective surgery.

Why is "Stop amlodipine on the day of surgery" not the answer?

Stopping a calcium channel blocker can cause rebound hypertension.

Why is "Give a large dose of a beta blocker preoperatively" not the answer?

A large single beta blocker dose may cause hypotension and bradycardia.

What concept does this question test?

It tests Preoperative assessment: hypertension in Anaesthesia. Antihypertensives are continued perioperatively, with ACE inhibitors and ARBs being the common exception. Severe hypertension at or above this level warrants optimisation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: hypertension?

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.