Perioperative care: postoperative oliguria: practice question

A General Surgery 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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General Surgery · Perioperative care: postoperative oliguria

Sample item

On the first day after bowel resection, a patient has urine output of 15 mL/h, a heart rate of 120, low blood pressure, dry mucosa, concentrated urine and a urinary sodium below 20 mmol/L. What is the best next step?

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

The answer and the reasoning

B. Crystalloid fluid bolus and reassessment

These findings indicate pre-renal oliguria from hypovolaemia, with avid sodium retention by the tubules. Treatment is a fluid challenge with reassessment of perfusion and urine output. Diuretics and dopamine do not protect the kidney and can worsen hypovolaemia.

Option by option

  • A. Urgent haemodialysis

    Dialysis is for refractory complications of renal failure and not for pre-renal oliguria.

  • B. Crystalloid fluid bolus and reassessment (correct)

    Correct. Hypovolaemia with sodium-avid kidneys is treated by fluid resuscitation.

  • C. Low-dose dopamine infusion

    Renal-dose dopamine has not been shown to protect renal function.

  • D. Intravenous furosemide

    Furosemide would deplete volume further in a hypovolaemic patient.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Crystalloid fluid bolus and reassessment. These findings indicate pre-renal oliguria from hypovolaemia, with avid sodium retention by the tubules.

Why is "Urgent haemodialysis" not the answer?

Dialysis is for refractory complications of renal failure and not for pre-renal oliguria.

Why is "Low-dose dopamine infusion" not the answer?

Renal-dose dopamine has not been shown to protect renal function.

Why is "Intravenous furosemide" not the answer?

Furosemide would deplete volume further in a hypovolaemic patient.

What concept does this question test?

It tests Perioperative care: postoperative oliguria in General Surgery. Treatment is a fluid challenge with reassessment of perfusion and urine output. Diuretics and dopamine do not protect the kidney and can worsen hypovolaemia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Perioperative care: postoperative oliguria?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.