Pharmacology: PONV prophylaxis with long QT: 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 · Pharmacology: PONV prophylaxis with long QT

Sample item

A patient with congenital long QT syndrome needs PONV prophylaxis for laparoscopic surgery. Which regimen is most appropriate?

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

The answer and the reasoning

C. Dexamethasone with propofol-based total intravenous anaesthesia, avoiding droperidol and ondansetron

Droperidol, haloperidol and ondansetron prolong the QT interval and can precipitate torsades de pointes in susceptible patients. Dexamethasone does not affect the QT interval, and propofol-based total intravenous anaesthesia reduces PONV by avoiding volatile agents. Reducing baseline risk and avoiding QT-prolonging combinations is the strategy.

Option by option

  • A. Haloperidol with ondansetron

    Haloperidol and ondansetron both prolong the QT interval.

  • B. Droperidol and ondansetron together

    Both droperidol and ondansetron prolong the QT interval.

  • C. Dexamethasone with propofol-based total intravenous anaesthesia, avoiding droperidol and ondansetron (correct)

    Correct. This approach avoids QT-prolonging drugs and reduces the baseline PONV risk.

  • D. Metoclopramide with droperidol

    Droperidol prolongs the QT interval, and metoclopramide adds risk.

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 C, Dexamethasone with propofol-based total intravenous anaesthesia, avoiding droperidol and ondansetron. Droperidol, haloperidol and ondansetron prolong the QT interval and can precipitate torsades de pointes in susceptible patients.

Why is "Haloperidol with ondansetron" not the answer?

Haloperidol and ondansetron both prolong the QT interval.

Why is "Droperidol and ondansetron together" not the answer?

Both droperidol and ondansetron prolong the QT interval.

Why is "Metoclopramide with droperidol" not the answer?

Droperidol prolongs the QT interval, and metoclopramide adds risk.

What concept does this question test?

It tests Pharmacology: PONV prophylaxis with long QT in Anaesthesia. Dexamethasone does not affect the QT interval, and propofol-based total intravenous anaesthesia reduces PONV by avoiding volatile agents. Reducing baseline risk and avoiding QT-prolonging combinations is the strategy.

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 Pharmacology: PONV prophylaxis with long QT?

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.