Preoperative assessment: Cushing syndrome: 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 · Preoperative assessment: Cushing syndrome

Sample item

A 38-year-old woman with Cushing syndrome is scheduled for adrenalectomy. Which preoperative and positioning concern is most relevant?

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

The answer and the reasoning

D. Control of hypertension, hyperglycaemia and hypokalaemia, with careful padding for fragile skin and osteoporosis

Cortisol excess causes hypertension, hyperglycaemia, hypokalaemia, obesity, osteoporosis, myopathy and thin fragile skin. These are optimised before surgery, positioning is gentle to avoid fractures and skin injury, and steroid cover is planned after adrenalectomy.

Option by option

  • A. Routine avoidance of positioning changes, since the skin is thickened

    The skin is thin and fragile rather than thickened, so care in positioning is needed.

  • B. Correction of hypoglycaemia with a dextrose infusion

    Cushing syndrome raises glucose; hypoglycaemia is not expected.

  • C. Treatment of hypotension and hyperkalaemia from mineralocorticoid deficiency

    Hypotension and hyperkalaemia describe adrenal insufficiency, which is the opposite state.

  • D. Control of hypertension, hyperglycaemia and hypokalaemia, with careful padding for fragile skin and osteoporosis (correct)

    Correct. These are the metabolic and tissue consequences of cortisol excess.

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, Control of hypertension, hyperglycaemia and hypokalaemia, with careful padding for fragile skin and osteoporosis. Cortisol excess causes hypertension, hyperglycaemia, hypokalaemia, obesity, osteoporosis, myopathy and thin fragile skin.

Why is "Routine avoidance of positioning changes, since the skin is thickened" not the answer?

The skin is thin and fragile rather than thickened, so care in positioning is needed.

Why is "Correction of hypoglycaemia with a dextrose infusion" not the answer?

Cushing syndrome raises glucose; hypoglycaemia is not expected.

Why is "Treatment of hypotension and hyperkalaemia from mineralocorticoid def…" not the answer?

Hypotension and hyperkalaemia describe adrenal insufficiency, which is the opposite state.

What concept does this question test?

It tests Preoperative assessment: Cushing syndrome in Anaesthesia. These are optimised before surgery, positioning is gentle to avoid fractures and skin injury, and steroid cover is planned after adrenalectomy.

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 Preoperative assessment: Cushing syndrome?

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.