Preoperative assessment: timing of dialysis before surgery: 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: timing of dialysis before surgery

Sample item

A patient with end-stage renal disease on maintenance haemodialysis is booked for elective surgery. When should dialysis ideally be arranged?

AOnly after surgery, because dialysis before anaesthesia is hazardousBOne week before surgery, so the fluid balance can stabiliseCImmediately before induction, with full heparin dosing continuingDWithin 24 hours before surgery, usually the day before

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

The answer and the reasoning

D. Within 24 hours before surgery, usually the day before

Dialysis the day before surgery corrects volume overload, hyperkalaemia and acidosis, and allows the heparin given during dialysis to wear off. Dialysis immediately before surgery risks residual heparin and fluid shifts.

Option by option

A. Only after surgery, because dialysis before anaesthesia is hazardous
Waiting until after surgery leaves the patient with uncorrected potassium and fluid during anaesthesia.
B. One week before surgery, so the fluid balance can stabilise
A week is too long, as fluid and potassium would accumulate again.
C. Immediately before induction, with full heparin dosing continuing
Surgery straight after dialysis exposes the patient to residual heparin and haemodynamic shifts.
D. Within 24 hours before surgery, usually the day before (correct)
Correct. Dialysis within 24 hours optimises potassium and volume while heparin effect has gone.

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 D, Within 24 hours before surgery, usually the day before. Dialysis the day before surgery corrects volume overload, hyperkalaemia and acidosis, and allows the heparin given during dialysis to wear off.

Why is "Only after surgery, because dialysis before anaesthesia is hazardous" not the answer?

Waiting until after surgery leaves the patient with uncorrected potassium and fluid during anaesthesia.

Why is "One week before surgery, so the fluid balance can stabilise" not the answer?

A week is too long, as fluid and potassium would accumulate again.

Why is "Immediately before induction, with full heparin dosing continuing" not the answer?

Surgery straight after dialysis exposes the patient to residual heparin and haemodynamic shifts.

What concept does this question test?

It tests Preoperative assessment: timing of dialysis before surgery in Anaesthesia. Dialysis immediately before surgery risks residual heparin and fluid shifts.

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: timing of dialysis before surgery?

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.