Preoperative assessment: statin therapy: 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: statin therapy

Sample item

A 68-year-old man with coronary artery disease takes atorvastatin daily and is scheduled for elective major vascular surgery. What should be done with the statin?

AReplace it with a fibrate until recoveryBStop it only on the morning of surgery and restart after bowel function returnsCContinue it throughout the perioperative periodDStop it a week before surgery to avoid myopathy

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

The answer and the reasoning

C. Continue it throughout the perioperative period

Statins are continued in patients already taking them, and may be started before vascular surgery in those with indications. Their plaque-stabilising and anti-inflammatory effects are thought to reduce perioperative cardiac events, and withdrawal is associated with worse outcomes.

Option by option

A. Replace it with a fibrate until recovery
A fibrate does not replace the plaque-stabilising effect of a statin and adds myopathy risk.
B. Stop it only on the morning of surgery and restart after bowel function returns
Withholding the drug around surgery removes its protective effect at the highest-risk time.
C. Continue it throughout the perioperative period (correct)
Correct. Continuing the statin is advised, as stopping is linked to more cardiac events.
D. Stop it a week before surgery to avoid myopathy
There is no good evidence that a week of interruption prevents myopathy, and stopping may be harmful.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Continue it throughout the perioperative period. Statins are continued in patients already taking them, and may be started before vascular surgery in those with indications.

Why is "Replace it with a fibrate until recovery" not the answer?

A fibrate does not replace the plaque-stabilising effect of a statin and adds myopathy risk.

Why is "Stop it only on the morning of surgery and restart after bowel functi…" not the answer?

Withholding the drug around surgery removes its protective effect at the highest-risk time.

Why is "Stop it a week before surgery to avoid myopathy" not the answer?

There is no good evidence that a week of interruption prevents myopathy, and stopping may be harmful.

What concept does this question test?

It tests Preoperative assessment: statin therapy in Anaesthesia. Their plaque-stabilising and anti-inflammatory effects are thought to reduce perioperative cardiac events, and withdrawal is associated with worse outcomes.

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 Preoperative assessment: statin therapy?

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.