Intravenous agents: dosing in the elderly: 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 agents: dosing in the elderly

Sample item

Why is the induction dose of propofol reduced in an elderly patient?

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

The answer and the reasoning

A. Lower central compartment volume and slower clearance increase sensitivity

Elderly patients have a smaller central volume of distribution, reduced cardiac output and altered pharmacodynamics, so a lower dose and slower injection prevent hypotension. Doses may be reduced by 30 to 50%.

Option by option

  • A. Lower central compartment volume and slower clearance increase sensitivity (correct)

    Correct. Reduced central volume and clearance raise effect.

  • B. Higher cardiac output speeds drug effect

    Cardiac output is reduced, not raised, with age.

  • C. Increased protein binding

    Binding does not increase.

  • D. Increased plasma cholinesterase

    Cholinesterase is unrelated to propofol.

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 A, Lower central compartment volume and slower clearance increase sensitivity. Elderly patients have a smaller central volume of distribution, reduced cardiac output and altered pharmacodynamics, so a lower dose and slower injection prevent hypotension.

Why is "Higher cardiac output speeds drug effect" not the answer?

Cardiac output is reduced, not raised, with age.

Why is "Increased protein binding" not the answer?

Binding does not increase.

Why is "Increased plasma cholinesterase" not the answer?

Cholinesterase is unrelated to propofol.

What concept does this question test?

It tests Intravenous agents: dosing in the elderly in Anaesthesia. Doses may be reduced by 30 to 50%.

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 agents: dosing in the elderly?

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.