ASA Physical Status Classification MCQ — NEET PG Practice Question | NEETPGAI
ASA Physical Status Classification
hard
syringe Anesthesia
A 58-year-old man with a history of stable angina, well-controlled hypertension, and mild chronic kidney disease (eGFR 45 mL/min/1.73m²) is scheduled for elective hernia repair. Regarding his ASA Physical Status classification, all of the following are correct EXCEPT:
A. His perioperative mortality risk is approximately 1–2% based on ASA PS classification alone
B. The presence of stable angina and CKD stage 3b warrants careful preoperative cardiac and renal assessment
C. His ASA PS classification would be upgraded to PS IV if the angina became unstable or if he developed acute kidney injury
D. This patient is classified as ASA PS III due to the presence of multiple severe systemic diseases
Explanation
Clinical Case Analysis: ASA PS Classification in Multimorbid Patient
Patient Summary
58-year-old male
Stable angina (controlled, not acute)
Well-controlled hypertension
Mild CKD (eGFR 45 = Stage 3b)
Elective hernia repair (non-emergency)
ASA PS Classification Decision
Key Point
ASA PS classification is based on the severity and functional impact of systemic disease, NOT the number of conditions.
This patient has multiple comorbidities but they are stable and controlled. The presence of multiple diseases does not automatically elevate the ASA PS grade if they are not functionally limiting or severe.
Correct ASA PS Assignment
Table
Feature
Assessment
Stable angina
Managed, not acute — does not limit activity
Hypertension
Well-controlled — no functional limitation
CKD Stage 3b
Mild renal impairment, eGFR 45 — asymptomatic
Overall functional status
No incapacity or significant limitation
Correct ASA PS Grade
PS II (mild systemic disease, no functional limitation)
High-YieldNEET PG
This patient is ASA PS II, not PS III. The key is that all conditions are stable and controlled, with no functional limitation. ASA PS III requires severe systemic disease that limits activity.
Analysis of Each Option
Option 0 (INCORRECT — THE ANSWER):
States the patient is ASA PS III due to "multiple severe systemic diseases"
This is wrong because:
1.
The diseases are controlled, not uncontrolled
2.
There is no functional limitation documented
3.
Stable angina does not limit activity in this patient
4.
The patient should be classified as ASA PS II, not PS III
Option 1 (CORRECT):
ASA PS II has perioperative mortality risk of ~0.4–1.8%
This statement is accurate for PS II classification
Option 2 (CORRECT):
Stable angina and CKD Stage 3b both warrant preoperative assessment
Cardiac risk stratification and renal function monitoring are appropriate
This is a clinically sound statement
Option 3 (CORRECT):
If angina became unstable (limiting activity, rest symptoms), PS would upgrade to PS III
If AKI developed (acute decompensation), PS could upgrade to PS III or IV
This represents appropriate risk stratification logic
Clinical Pearl
Warning
A common mistake is equating "multiple comorbidities" with higher ASA PS grade. The ASA PS system grades severity and functional impact, not disease count. A patient with 5 well-controlled conditions may be PS I or II; a patient with 1 severe, uncontrolled condition may be PS III or IV.
