Antidiabetic drugs: metformin: practice question

A Pharmacology 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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Pharmacology · Antidiabetic drugs: metformin

Sample item

Which condition is a strong reason to withhold metformin because of increased lactic acidosis risk?

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

The answer and the reasoning

D. Severe acute kidney injury with tissue hypoperfusion

Metformin accumulation and poor tissue perfusion both increase the risk of rare but serious lactic acidosis. It should be paused in severe acute illness causing hypoxia, shock, or acute renal failure.

Option by option

  • A. Seasonal allergic rhinitis

    Rhinitis does not impair metformin clearance or oxygen delivery.

  • B. Controlled essential hypertension

    Controlled hypertension alone is not a reason to stop metformin.

  • C. Uncomplicated hypercholesterolaemia

    Hypercholesterolaemia is not a contraindication.

  • D. Severe acute kidney injury with tissue hypoperfusion (correct)

    Correct. Renal failure and hypoperfusion are high-risk settings.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Severe acute kidney injury with tissue hypoperfusion. Metformin accumulation and poor tissue perfusion both increase the risk of rare but serious lactic acidosis.

Why is "Seasonal allergic rhinitis" not the answer?

Rhinitis does not impair metformin clearance or oxygen delivery.

Why is "Controlled essential hypertension" not the answer?

Controlled hypertension alone is not a reason to stop metformin.

Why is "Uncomplicated hypercholesterolaemia" not the answer?

Hypercholesterolaemia is not a contraindication.

What concept does this question test?

It tests Antidiabetic drugs: metformin in Pharmacology. It should be paused in severe acute illness causing hypoxia, shock, or acute renal failure.

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 Antidiabetic drugs: metformin?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.