Special anaesthesia: Duchenne muscular dystrophy: 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 · Special anaesthesia: Duchenne muscular dystrophy

Sample item

A 7-year-old boy with Duchenne muscular dystrophy is scheduled for an orthopaedic procedure. Which anaesthetic plan is safest?

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

The answer and the reasoning

C. Total intravenous anaesthesia with a non-depolarising relaxant, avoiding suxamethonium and volatile agents

In dystrophinopathies, suxamethonium and volatile agents can cause rhabdomyolysis with severe hyperkalaemia and cardiac arrest. Total intravenous anaesthesia and a non-depolarising agent avoid these triggers. Respiratory and cardiac function should also be assessed before surgery.

Option by option

  • A. Isoflurane maintenance with suxamethonium boluses

    Isoflurane and suxamethonium can both trigger rhabdomyolysis.

  • B. Sevoflurane induction with suxamethonium for intubation

    Volatile agents and suxamethonium can both trigger rhabdomyolysis in this condition.

  • C. Total intravenous anaesthesia with a non-depolarising relaxant, avoiding suxamethonium and volatile agents (correct)

    Correct. Avoiding both suxamethonium and volatiles prevents rhabdomyolysis and hyperkalaemic arrest.

  • D. Halothane with suxamethonium infusion

    Halothane and suxamethonium are both hazardous in muscular dystrophy.

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 C, Total intravenous anaesthesia with a non-depolarising relaxant, avoiding suxamethonium and volatile agents. In dystrophinopathies, suxamethonium and volatile agents can cause rhabdomyolysis with severe hyperkalaemia and cardiac arrest.

Why is "Isoflurane maintenance with suxamethonium boluses" not the answer?

Isoflurane and suxamethonium can both trigger rhabdomyolysis.

Why is "Sevoflurane induction with suxamethonium for intubation" not the answer?

Volatile agents and suxamethonium can both trigger rhabdomyolysis in this condition.

Why is "Halothane with suxamethonium infusion" not the answer?

Halothane and suxamethonium are both hazardous in muscular dystrophy.

What concept does this question test?

It tests Special anaesthesia: Duchenne muscular dystrophy in Anaesthesia. Total intravenous anaesthesia and a non-depolarising agent avoid these triggers. Respiratory and cardiac function should also be assessed before surgery.

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 Special anaesthesia: Duchenne muscular dystrophy?

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.