Fluids: normal saline: 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 · Fluids: normal saline

Sample item

Large-volume 0.9% saline infusion is associated with which acid-base disturbance?

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

The answer and the reasoning

D. Hyperchloraemic normal anion gap metabolic acidosis

Saline has a chloride content of 154 mEq/L, which exceeds that of plasma, so large volumes cause dilutional and hyperchloraemic acidosis. Balanced crystalloids avoid this.

Option by option

  • A. Respiratory alkalosis

    Respiratory changes are not primary.

  • B. High anion gap acidosis

    The anion gap is normal.

  • C. Metabolic alkalosis

    Alkalosis is not expected.

  • D. Hyperchloraemic normal anion gap metabolic acidosis (correct)

    Correct. Chloride load causes hyperchloraemic acidosis.

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, Hyperchloraemic normal anion gap metabolic acidosis. Saline has a chloride content of 154 mEq/L, which exceeds that of plasma, so large volumes cause dilutional and hyperchloraemic acidosis.

Why is "Respiratory alkalosis" not the answer?

Respiratory changes are not primary.

Why is "High anion gap acidosis" not the answer?

The anion gap is normal.

Why is "Metabolic alkalosis" not the answer?

Alkalosis is not expected.

What concept does this question test?

It tests Fluids: normal saline in Anaesthesia. Balanced crystalloids avoid this.

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 Fluids: normal saline?

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.