Neuromuscular blockade: succinylcholine: 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 · Neuromuscular blockade: succinylcholine

Sample item

Which patient is at greatest risk of dangerous hyperkalaemia after succinylcholine?

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

The answer and the reasoning

A. A patient with a major burn sustained two weeks earlier

Burns, denervation injuries and prolonged immobilisation upregulate extrajunctional acetylcholine receptors. Succinylcholine can then cause massive potassium efflux and arrhythmia.

Option by option

  • A. A patient with a major burn sustained two weeks earlier (correct)

    Correct. Burn-related receptor upregulation makes succinylcholine hazardous after the acute period.

  • B. A patient receiving a single dose of cefazolin

    Cefazolin does not create acetylcholine-receptor upregulation.

  • C. A patient with controlled hypothyroidism

    Controlled hypothyroidism is not the classic hyperkalaemia risk.

  • D. A healthy adult for elective surgery

    Healthy patients generally have a small predictable potassium rise only.

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 patient with a major burn sustained two weeks earlier. Burns, denervation injuries and prolonged immobilisation upregulate extrajunctional acetylcholine receptors.

Why is "A patient receiving a single dose of cefazolin" not the answer?

Cefazolin does not create acetylcholine-receptor upregulation.

Why is "A patient with controlled hypothyroidism" not the answer?

Controlled hypothyroidism is not the classic hyperkalaemia risk.

Why is "A healthy adult for elective surgery" not the answer?

Healthy patients generally have a small predictable potassium rise only.

What concept does this question test?

It tests Neuromuscular blockade: succinylcholine in Anaesthesia. Succinylcholine can then cause massive potassium efflux and arrhythmia.

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 Neuromuscular blockade: succinylcholine?

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.