Malignant hyperthermia: 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 · Malignant hyperthermia

Sample item

Soon after volatile anesthesia begins, end-tidal CO2 rises rapidly despite increased ventilation, with generalized rigidity, tachycardia, and increasing temperature. What is the specific treatment?

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

The answer and the reasoning

A. Dantrolene and discontinuation of triggering agents

Malignant hyperthermia is a hypermetabolic crisis triggered by volatile anesthetics or succinylcholine in susceptible individuals. Immediate treatment includes stopping triggers, administering dantrolene, active supportive management, and treating complications such as hyperkalemia.

Option by option

  • A. Dantrolene and discontinuation of triggering agents (correct)

    Correct. Dantrolene directly reduces abnormal skeletal-muscle calcium release.

  • B. Neostigmine and atropine

    Neostigmine and atropine are used for reversal of some nondepolarizing blocks.

  • C. Naloxone infusion

    Naloxone reverses opioid effects, not this hypermetabolic crisis.

  • D. Intravenous insulin only

    Insulin may help treat hyperkalemia but is not definitive treatment for malignant hyperthermia.

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, Dantrolene and discontinuation of triggering agents. Malignant hyperthermia is a hypermetabolic crisis triggered by volatile anesthetics or succinylcholine in susceptible individuals.

Why is "Neostigmine and atropine" not the answer?

Neostigmine and atropine are used for reversal of some nondepolarizing blocks.

Why is "Naloxone infusion" not the answer?

Naloxone reverses opioid effects, not this hypermetabolic crisis.

Why is "Intravenous insulin only" not the answer?

Insulin may help treat hyperkalemia but is not definitive treatment for malignant hyperthermia.

What concept does this question test?

It tests Malignant hyperthermia in Anaesthesia. Immediate treatment includes stopping triggers, administering dantrolene, active supportive management, and treating complications such as hyperkalemia.

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 Malignant hyperthermia?

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.