American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What syndrome is associated with propofol infusion at high rates?

1. Neuroleptic malignant syndrome

2. Propofol infusion syndrome

3. Malignant hyperthermia

4. Serotonin syndrome

The correct answer is: Propofol infusion syndrome

Propofol infusion syndrome is specifically linked to the extensive use of propofol at high rates, particularly in the setting of long-term sedation or anesthetic management. This condition is characterized by a combination of metabolic acidosis, cardiac failure, renal failure, and rhabdomyolysis. The syndrome is thought to result from the effects of propofol on fatty acid metabolism, particularly in patients with critical illness or those receiving large doses over prolonged periods. The association of propofol with these severe complications highlights the importance of monitoring patients who are on high-dose infusions of the drug. In cases where propofol infusion is used, especially in the intensive care setting, clinicians are advised to be vigilant for signs of this potentially devastating condition. Other syndromes mentioned also have their own specific etiologies and mechanisms, but they do not share the same direct association with propofol use. For instance, neuroleptic malignant syndrome is typically associated with antipsychotic medications, malignant hyperthermia is a hypermetabolic response to certain anesthetic agents in susceptible individuals, and serotonin syndrome results from increased serotonergic activity, often due to specific medications affecting serotonin levels. These conditions do not directly correlate with propofol infusion practices.