Cardiovascular physiology, fluids, and blood management: curriculum recognition: 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 · Cardiovascular physiology, fluids, and blood management: curriculum recognition

Sample item

A 58-year-old man on amlodipine arrives for elective inguinal hernia repair. His blood pressure is 154/96 mmHg and he has no symptoms or end-organ damage. What is the best plan?

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

The answer and the reasoning

B. Proceed and continue the antihypertensive

Mild to moderate hypertension without end-organ damage does not increase perioperative risk enough to postpone surgery. Treatment is normally continued up to the morning of surgery, and surgery is deferred only for severe hypertension, around 180/110 or more. Abrupt lowering is itself harmful.

Option by option

  • A. Give intravenous labetalol until the pressure is below 120/80

    Aggressive acute lowering risks hypotension and organ hypoperfusion.

  • B. Proceed and continue the antihypertensive (correct)

    Correct. Surgery proceeds and antihypertensive drugs are continued.

  • C. Omit amlodipine on the morning of surgery

    Stopping the drug risks rebound hypertension on the day of surgery.

  • D. Postpone surgery for six weeks of blood pressure control

    Postponement is reserved for severe or symptomatic hypertension.

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 B, Proceed and continue the antihypertensive. Mild to moderate hypertension without end-organ damage does not increase perioperative risk enough to postpone surgery.

Why is "Give intravenous labetalol until the pressure is below 120/80" not the answer?

Aggressive acute lowering risks hypotension and organ hypoperfusion.

Why is "Omit amlodipine on the morning of surgery" not the answer?

Stopping the drug risks rebound hypertension on the day of surgery.

Why is "Postpone surgery for six weeks of blood pressure control" not the answer?

Postponement is reserved for severe or symptomatic hypertension.

What concept does this question test?

It tests Cardiovascular physiology, fluids, and blood management: curriculum recognition in Anaesthesia. Treatment is normally continued up to the morning of surgery, and surgery is deferred only for severe hypertension, around 180/110 or more. Abrupt lowering is itself harmful.

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 Cardiovascular physiology, fluids, and blood management: curriculum recognition?

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.