Intravenous and inhalational agents: central sensitisation and pre-emptive analgesia: 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 · Intravenous and inhalational agents: central sensitisation and pre-emptive analgesia

Sample item

Central sensitisation, or wind-up, after tissue injury makes the dorsal horn hyperexcitable and underlies the use of ketamine and magnesium in analgesia. Which receptor is mainly involved?

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

The answer and the reasoning

C. NMDA receptor

Repeated C-fibre input causes glutamate release and activation of NMDA receptors, producing wind-up and hyperalgesia. Ketamine and magnesium block the NMDA channel, which is why they reduce opioid requirement and chronic pain risk.

Option by option

  • A. Alpha-2 adrenergic receptor

    Alpha-2 receptors are targeted by clonidine and dexmedetomidine.

  • B. GABA-A receptor

    GABA-A receptors mediate the effects of benzodiazepines, propofol and volatile agents.

  • C. NMDA receptor (correct)

    Correct. NMDA receptor activation drives central sensitisation.

  • D. Mu opioid receptor

    Mu receptors are the target of opioids and not of the wind-up mechanism itself.

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 C, NMDA receptor. Repeated C-fibre input causes glutamate release and activation of NMDA receptors, producing wind-up and hyperalgesia.

Why is "Alpha-2 adrenergic receptor" not the answer?

Alpha-2 receptors are targeted by clonidine and dexmedetomidine.

Why is "GABA-A receptor" not the answer?

GABA-A receptors mediate the effects of benzodiazepines, propofol and volatile agents.

Why is "Mu opioid receptor" not the answer?

Mu receptors are the target of opioids and not of the wind-up mechanism itself.

What concept does this question test?

It tests Intravenous and inhalational agents: central sensitisation and pre-emptive analgesia in Anaesthesia. Ketamine and magnesium block the NMDA channel, which is why they reduce opioid requirement and chronic pain risk.

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 Intravenous and inhalational agents: central sensitisation and pre-emptive analgesia?

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.