Preoperative assessment: renal transplant recipient: 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 · Preoperative assessment: renal transplant recipient

Sample item

A patient who received a kidney transplant two years ago and takes tacrolimus and prednisolone needs elective surgery. Which perioperative management is appropriate?

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

The answer and the reasoning

D. Continue the immunosuppressants, use strict asepsis, and avoid nephrotoxic drugs such as NSAIDs

Immunosuppression is continued to avoid rejection, and infection risk is high so aseptic technique and prophylactic antibiotics matter. Nephrotoxic drugs, hypotension and hypovolaemia are avoided to protect the graft, and long-term steroid users need stress-dose cover.

Option by option

  • A. Use NSAIDs for analgesia, since the graft is well established

    NSAIDs reduce renal blood flow and can damage the graft.

  • B. Omit the steroid, as stress-dose cover is never required

    Patients on long-term steroids may need perioperative stress-dose cover.

  • C. Stop immunosuppression perioperatively to aid wound healing

    Stopping immunosuppression risks acute graft rejection.

  • D. Continue the immunosuppressants, use strict asepsis, and avoid nephrotoxic drugs such as NSAIDs (correct)

    Correct. This protects graft function and limits infection 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 D, Continue the immunosuppressants, use strict asepsis, and avoid nephrotoxic drugs such as NSAIDs. Immunosuppression is continued to avoid rejection, and infection risk is high so aseptic technique and prophylactic antibiotics matter.

Why is "Use NSAIDs for analgesia, since the graft is well established" not the answer?

NSAIDs reduce renal blood flow and can damage the graft.

Why is "Omit the steroid, as stress-dose cover is never required" not the answer?

Patients on long-term steroids may need perioperative stress-dose cover.

Why is "Stop immunosuppression perioperatively to aid wound healing" not the answer?

Stopping immunosuppression risks acute graft rejection.

What concept does this question test?

It tests Preoperative assessment: renal transplant recipient in Anaesthesia. Nephrotoxic drugs, hypotension and hypovolaemia are avoided to protect the graft, and long-term steroid users need stress-dose cover.

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 Preoperative assessment: renal transplant recipient?

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.