Intravenous and inhalational agents: desflurane sympathetic response: 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: desflurane sympathetic response

Sample item

During maintenance, the anaesthetist abruptly raises desflurane from 4 to 10 percent, and heart rate and blood pressure surge. What is the mechanism?

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

The answer and the reasoning

B. Airway irritation causes transient sympathetic activation

A rapid rise in desflurane concentration stimulates airway receptors and causes a transient sympathetic discharge, with tachycardia and hypertension. It can be reduced by increasing the concentration gradually or by giving an opioid or beta blocker.

Option by option

  • A. Direct beta-receptor stimulation

    Desflurane has no beta agonist action.

  • B. Airway irritation causes transient sympathetic activation (correct)

    Correct. Airway receptor stimulation produces a short sympathetic surge.

  • C. Histamine release from mast cells

    Desflurane is not a histamine releaser.

  • D. Inhibition of catecholamine reuptake as with cocaine

    Inhibition of catecholamine reuptake is not how desflurane acts.

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 B, Airway irritation causes transient sympathetic activation. A rapid rise in desflurane concentration stimulates airway receptors and causes a transient sympathetic discharge, with tachycardia and hypertension.

Why is "Direct beta-receptor stimulation" not the answer?

Desflurane has no beta agonist action.

Why is "Histamine release from mast cells" not the answer?

Desflurane is not a histamine releaser.

Why is "Inhibition of catecholamine reuptake as with cocaine" not the answer?

Inhibition of catecholamine reuptake is not how desflurane acts.

What concept does this question test?

It tests Intravenous and inhalational agents: desflurane sympathetic response in Anaesthesia. It can be reduced by increasing the concentration gradually or by giving an opioid or beta blocker.

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: desflurane sympathetic response?

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.