Intravenous and inhalational agents: tolerance to morphine effects: 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: tolerance to morphine effects

Sample item

A cancer patient on long-term oral morphine needs increasing doses for the same pain relief but still has constricted pupils and constipation. Which statement is correct?

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

The answer and the reasoning

D. Tolerance develops to analgesia and respiratory depression, but little to miosis and constipation

With chronic opioid use tolerance develops to analgesia, euphoria, sedation and respiratory depression. Little tolerance develops to miosis and to constipation, so a laxative is prescribed along with long-term opioids.

Option by option

  • A. Tolerance develops to miosis and constipation first and to analgesia last

    This reverses the pattern seen in practice.

  • B. Tolerance develops equally to all the effects of morphine

    Tolerance is not uniform across the effects.

  • C. No tolerance develops to any effect of morphine

    Tolerance does develop, which is why doses must rise.

  • D. Tolerance develops to analgesia and respiratory depression, but little to miosis and constipation (correct)

    Correct. Tolerance spares miosis and constipation.

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, Tolerance develops to analgesia and respiratory depression, but little to miosis and constipation. With chronic opioid use tolerance develops to analgesia, euphoria, sedation and respiratory depression.

Why is "Tolerance develops to miosis and constipation first and to analgesia…" not the answer?

This reverses the pattern seen in practice.

Why is "Tolerance develops equally to all the effects of morphine" not the answer?

Tolerance is not uniform across the effects.

Why is "No tolerance develops to any effect of morphine" not the answer?

Tolerance does develop, which is why doses must rise.

What concept does this question test?

It tests Intravenous and inhalational agents: tolerance to morphine effects in Anaesthesia. Little tolerance develops to miosis and to constipation, so a laxative is prescribed along with long-term opioids.

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: tolerance to morphine effects?

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.