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

In recovery after major abdominal surgery, a patient has tachycardia, a blood pressure of 85/50 mmHg, cold peripheries, a narrow pulse pressure and low urine output. What is the most likely cause?

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

The answer and the reasoning

B. Hypovolaemia from bleeding or inadequate fluid

Hypovolaemia is the commonest cause of postoperative hypotension, and cold peripheries with a narrow pulse pressure show a compensatory rise in vascular tone. A residual sympathetic block would give warm, vasodilated skin. Exclude bleeding and give fluid or blood.

Option by option

  • A. Pulmonary embolism

    Pulmonary embolism typically causes hypoxia and a raised venous pressure.

  • B. Hypovolaemia from bleeding or inadequate fluid (correct)

    Correct. Cold, narrow-pulse-pressure shock after surgery most often reflects volume loss.

  • C. Residual neuraxial block

    A residual block gives vasodilation with warm peripheries.

  • D. Acute myocardial infarction

    Myocardial infarction is possible but much less common and usually has chest pain or ECG changes.

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, Hypovolaemia from bleeding or inadequate fluid. Hypovolaemia is the commonest cause of postoperative hypotension, and cold peripheries with a narrow pulse pressure show a compensatory rise in vascular tone.

Why is "Pulmonary embolism" not the answer?

Pulmonary embolism typically causes hypoxia and a raised venous pressure.

Why is "Residual neuraxial block" not the answer?

A residual block gives vasodilation with warm peripheries.

Why is "Acute myocardial infarction" not the answer?

Myocardial infarction is possible but much less common and usually has chest pain or ECG changes.

What concept does this question test?

It tests Cardiovascular physiology, fluids, and blood management: curriculum recognition in Anaesthesia. A residual sympathetic block would give warm, vasodilated skin. Exclude bleeding and give fluid or blood.

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.