Colon: Ogilvie syndrome: 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 · Colon: Ogilvie syndrome

Sample item

A bedridden patient after hip surgery has massive caecal dilatation of 11 cm with no mechanical obstruction on CT and no peritonitis. Conservative measures fail. Which drug is used?

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

The answer and the reasoning

D. Intravenous neostigmine

Ogilvie syndrome is acute colonic pseudo-obstruction and carries a risk of caecal perforation when the diameter exceeds 10 to 12 cm. After excluding mechanical obstruction and correcting electrolytes, neostigmine is effective under cardiac monitoring because it enhances parasympathetic activity. Colonoscopic decompression is the next step if it fails.

Option by option

  • A. Intravenous morphine

    Opioids slow motility and worsen the condition.

  • B. Oral senna

    Stimulant laxatives are unsafe in a massively distended colon.

  • C. Intravenous metoclopramide alone

    Metoclopramide has limited effect on colonic motility.

  • D. Intravenous neostigmine (correct)

    Correct. Neostigmine restores colonic motility in pseudo-obstruction.

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 D, Intravenous neostigmine. Ogilvie syndrome is acute colonic pseudo-obstruction and carries a risk of caecal perforation when the diameter exceeds 10 to 12 cm.

Why is "Intravenous morphine" not the answer?

Opioids slow motility and worsen the condition.

Why is "Oral senna" not the answer?

Stimulant laxatives are unsafe in a massively distended colon.

Why is "Intravenous metoclopramide alone" not the answer?

Metoclopramide has limited effect on colonic motility.

What concept does this question test?

It tests Colon: Ogilvie syndrome in General Surgery. After excluding mechanical obstruction and correcting electrolytes, neostigmine is effective under cardiac monitoring because it enhances parasympathetic activity. Colonoscopic decompression is the next step if it fails.

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 Colon: Ogilvie syndrome?

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.