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 trauma patient in haemorrhagic shock is receiving a massive transfusion protocol. Which ratio of red cells, plasma and platelets is generally aimed for, to approximate whole blood?

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

The answer and the reasoning

C. Red cells, plasma and platelets in about 1:1:1

Balanced resuscitation with red cells, plasma and platelets in roughly equal proportions reduces dilutional coagulopathy and early death from haemorrhage. Giving red cells alone or with a lot of crystalloid dilutes clotting factors and platelets.

Option by option

  • A. Red cells, plasma and platelets in about 10:1:1

    A ratio of 10:1:1 is red-cell dominated and leads to coagulopathy.

  • B. Red cells alone until bleeding is controlled

    Red cells alone provide no clotting factors or platelets.

  • C. Red cells, plasma and platelets in about 1:1:1 (correct)

    Correct. A balanced ratio close to 1:1:1 replaces what is lost.

  • D. Red cells, plasma and platelets in about 4:1:1

    A red-cell-heavy ratio dilutes clotting factors and platelets.

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 C, Red cells, plasma and platelets in about 1:1:1. Balanced resuscitation with red cells, plasma and platelets in roughly equal proportions reduces dilutional coagulopathy and early death from haemorrhage.

Why is "Red cells, plasma and platelets in about 10:1:1" not the answer?

A ratio of 10:1:1 is red-cell dominated and leads to coagulopathy.

Why is "Red cells alone until bleeding is controlled" not the answer?

Red cells alone provide no clotting factors or platelets.

Why is "Red cells, plasma and platelets in about 4:1:1" not the answer?

A red-cell-heavy ratio dilutes clotting factors and platelets.

What concept does this question test?

It tests Cardiovascular physiology, fluids, and blood management: curriculum recognition in Anaesthesia. Giving red cells alone or with a lot of crystalloid dilutes clotting factors and platelets.

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.