Preoperative assessment: echocardiography for a murmur: 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: echocardiography for a murmur

Sample item

A 70-year-old man with exertional breathlessness and a new ejection systolic murmur radiating to the carotids is listed for elective hip replacement. Which preoperative investigation is most appropriate?

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

The answer and the reasoning

C. Transthoracic echocardiography

A new murmur with symptoms suggests significant valvular disease, most likely aortic stenosis, and echocardiography defines its severity, which decides whether elective surgery should proceed. Routine imaging in asymptomatic patients is not needed, but symptoms with a murmur are an indication.

Option by option

  • A. Chest radiograph

    A chest radiograph does not quantify the valve lesion.

  • B. Coronary angiography

    Angiography is invasive and is not the first test for a suspected valve lesion.

  • C. Transthoracic echocardiography (correct)

    Correct. Echocardiography assesses valve area, gradient and ventricular function.

  • D. Pulmonary function tests

    Lung function testing does not explain a carotid-radiating systolic murmur.

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, Transthoracic echocardiography. A new murmur with symptoms suggests significant valvular disease, most likely aortic stenosis, and echocardiography defines its severity, which decides whether elective surgery should proceed.

Why is "Chest radiograph" not the answer?

A chest radiograph does not quantify the valve lesion.

Why is "Coronary angiography" not the answer?

Angiography is invasive and is not the first test for a suspected valve lesion.

Why is "Pulmonary function tests" not the answer?

Lung function testing does not explain a carotid-radiating systolic murmur.

What concept does this question test?

It tests Preoperative assessment: echocardiography for a murmur in Anaesthesia. Routine imaging in asymptomatic patients is not needed, but symptoms with a murmur are an indication.

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: echocardiography for a murmur?

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.