Perioperative care: induction agent in hypovolaemia: practice question

A General Surgery 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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General Surgery · Perioperative care: induction agent in hypovolaemia

Sample item

A bronchial asthmatic patient with hypovolaemia from intestinal obstruction needs a rapid sequence induction. Which induction agent is most suitable?

APropofolBMidazolamCThiopentoneDKetamine

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

The answer and the reasoning

D. Ketamine

Ketamine stimulates the sympathetic system, maintaining blood pressure and heart rate, and it is a bronchodilator. This suits shocked and asthmatic patients. Propofol and thiopentone cause vasodilatation and myocardial depression, so hypotension may be severe in hypovolaemia.

Option by option

A. Propofol
Propofol causes marked vasodilatation and hypotension in hypovolaemic patients.
B. Midazolam
Midazolam is slow in onset and a poor choice for rapid sequence induction.
C. Thiopentone
Thiopentone causes hypotension and can provoke bronchospasm.
D. Ketamine (correct)
Correct. Ketamine preserves haemodynamics and relaxes bronchial smooth muscle.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Ketamine. Ketamine stimulates the sympathetic system, maintaining blood pressure and heart rate, and it is a bronchodilator.

Why is "Propofol" not the answer?

Propofol causes marked vasodilatation and hypotension in hypovolaemic patients.

Why is "Midazolam" not the answer?

Midazolam is slow in onset and a poor choice for rapid sequence induction.

Why is "Thiopentone" not the answer?

Thiopentone causes hypotension and can provoke bronchospasm.

What concept does this question test?

It tests Perioperative care: induction agent in hypovolaemia in General Surgery. This suits shocked and asthmatic patients. Propofol and thiopentone cause vasodilatation and myocardial depression, so hypotension may be severe in hypovolaemia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Perioperative care: induction agent in hypovolaemia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.