Critical care: practice question

A General Medicine 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 Medicine · Critical care

Sample item

A man develops widespread urticaria, lip swelling, wheeze and hypotension within minutes of a wasp sting. Which is the single most important first drug?

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

The answer and the reasoning

A. Intramuscular adrenaline

Airway swelling, bronchospasm and hypotension after an allergen exposure indicate anaphylaxis. Adrenaline given intramuscularly into the anterolateral thigh is the first-line, life-saving drug because it reverses vasodilatation, oedema and bronchospasm, and the other agents are adjuncts.

Option by option

  • A. Intramuscular adrenaline (correct)

    Correct. Early intramuscular adrenaline is the cornerstone of anaphylaxis treatment.

  • B. Intravenous chlorpheniramine

    Antihistamines relieve itching and urticaria but do not treat shock or airway obstruction.

  • C. Intravenous hydrocortisone

    Hydrocortisone acts slowly and does not reverse the immediate life-threatening features.

  • D. Nebulised salbutamol

    Salbutamol may help wheeze but does not treat hypotension or laryngeal oedema.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Intramuscular adrenaline. Airway swelling, bronchospasm and hypotension after an allergen exposure indicate anaphylaxis.

Why is "Intravenous chlorpheniramine" not the answer?

Antihistamines relieve itching and urticaria but do not treat shock or airway obstruction.

Why is "Intravenous hydrocortisone" not the answer?

Hydrocortisone acts slowly and does not reverse the immediate life-threatening features.

Why is "Nebulised salbutamol" not the answer?

Salbutamol may help wheeze but does not treat hypotension or laryngeal oedema.

What concept does this question test?

It tests Critical care in General Medicine. Adrenaline given intramuscularly into the anterolateral thigh is the first-line, life-saving drug because it reverses vasodilatation, oedema and bronchospasm, and the other agents are adjuncts.

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 Critical care?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.