Adrenal: phaeochromocytoma: practice question

A General Surgery 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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General Surgery · Adrenal: phaeochromocytoma

Sample item

A 40-year-old man with biochemically confirmed phaeochromocytoma is being prepared for adrenalectomy. What is the correct pharmacological preparation?

AA beta-blocker first, then an alpha-blockerBPhenoxybenzamine first, with a beta-blocker added laterCA beta-blocker aloneDA diuretic and a salt-restricted diet

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

The answer and the reasoning

B. Phenoxybenzamine first, with a beta-blocker added later

Alpha blockade is started 10 to 14 days before surgery to control hypertension and restore plasma volume. A beta-blocker is added only afterwards for tachycardia, because blocking beta receptors first leaves unopposed alpha vasoconstriction and can precipitate a hypertensive crisis or pulmonary oedema.

Option by option

A. A beta-blocker first, then an alpha-blocker
Starting with a beta-blocker leaves alpha-mediated vasoconstriction unopposed.
B. Phenoxybenzamine first, with a beta-blocker added later (correct)
Correct. Alpha blockade comes first, then beta blockade for tachycardia.
C. A beta-blocker alone
A beta-blocker alone carries the same risk of unopposed alpha effects.
D. A diuretic and a salt-restricted diet
Salt restriction and diuretics worsen the volume depletion that these patients already have.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Phenoxybenzamine first, with a beta-blocker added later. Alpha blockade is started 10 to 14 days before surgery to control hypertension and restore plasma volume.

Why is "A beta-blocker first, then an alpha-blocker" not the answer?

Starting with a beta-blocker leaves alpha-mediated vasoconstriction unopposed.

Why is "A beta-blocker alone" not the answer?

A beta-blocker alone carries the same risk of unopposed alpha effects.

Why is "A diuretic and a salt-restricted diet" not the answer?

Salt restriction and diuretics worsen the volume depletion that these patients already have.

What concept does this question test?

It tests Adrenal: phaeochromocytoma in General Surgery. A beta-blocker is added only afterwards for tachycardia, because blocking beta receptors first leaves unopposed alpha vasoconstriction and can precipitate a hypertensive crisis or pulmonary oedema.

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 Adrenal: phaeochromocytoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.