Complications: tourniquet deflation: 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 · Complications: tourniquet deflation

Sample item

A lower limb tourniquet has been inflated for 2 hours. What changes are expected shortly after deflation?

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

The answer and the reasoning

A. A transient rise in end-tidal CO2 with a fall in blood pressure

Release of a long-duration tourniquet washes out acidic, hypoxic blood and metabolites such as lactate, CO2 and potassium into the circulation. This produces a transient rise in ETCO2, a fall in blood pressure from vasodilation and a fall in core temperature. Hypotension usually responds to fluid and a small dose of vasopressor.

Option by option

  • A. A transient rise in end-tidal CO2 with a fall in blood pressure (correct)

    Correct. Washout of metabolites raises ETCO2 and lowers blood pressure briefly.

  • B. A sudden fall in end-tidal CO2 with hypertension

    ETCO2 rises rather than falls, and blood pressure falls.

  • C. A rise in core temperature

    Cooler blood returns from the limb and core temperature falls.

  • D. A fall in serum potassium

    Potassium tends to rise after reperfusion.

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, A transient rise in end-tidal CO2 with a fall in blood pressure. Release of a long-duration tourniquet washes out acidic, hypoxic blood and metabolites such as lactate, CO2 and potassium into the circulation.

Why is "A sudden fall in end-tidal CO2 with hypertension" not the answer?

ETCO2 rises rather than falls, and blood pressure falls.

Why is "A rise in core temperature" not the answer?

Cooler blood returns from the limb and core temperature falls.

Why is "A fall in serum potassium" not the answer?

Potassium tends to rise after reperfusion.

What concept does this question test?

It tests Complications: tourniquet deflation in Anaesthesia. This produces a transient rise in ETCO2, a fall in blood pressure from vasodilation and a fall in core temperature. Hypotension usually responds to fluid and a small dose of vasopressor.

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 Complications: tourniquet deflation?

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.