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 patient receives several litres of Hartmann's solution. The lactate it contains is metabolised, mainly in the liver, to which buffering anion?

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

The answer and the reasoning

D. Bicarbonate

Lactate is converted in the liver, through pyruvate, to bicarbonate, so the solution does not cause the hyperchloraemic acidosis seen with large volumes of 0.9 percent saline. Severe liver failure can slow this conversion.

Option by option

  • A. Sulphate

    Sulphate is a metabolite of sulphur-containing compounds, not of lactate.

  • B. Phosphate

    Phosphate is not a product of lactate metabolism.

  • C. Chloride

    Chloride is the anion that accumulates with saline and is not generated from lactate.

  • D. Bicarbonate (correct)

    Correct. Hepatic metabolism of lactate yields bicarbonate.

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, Bicarbonate. Lactate is converted in the liver, through pyruvate, to bicarbonate, so the solution does not cause the hyperchloraemic acidosis seen with large volumes of 0.

Why is "Sulphate" not the answer?

Sulphate is a metabolite of sulphur-containing compounds, not of lactate.

Why is "Phosphate" not the answer?

Phosphate is not a product of lactate metabolism.

Why is "Chloride" not the answer?

Chloride is the anion that accumulates with saline and is not generated from lactate.

What concept does this question test?

It tests Cardiovascular physiology, fluids, and blood management: curriculum recognition in Anaesthesia. 9 percent saline. Severe liver failure can slow this conversion.

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.