Airway complications: 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 · Airway complications

Sample item

During emergence from light anaesthesia, a patient develops a crowing noise that suddenly becomes silent, with paradoxical chest and abdominal movement and falling saturation. What is the first step?

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

The answer and the reasoning

C. Remove the stimulus, apply jaw thrust and give 100% oxygen with CPAP

This is laryngospasm, a reflex adduction of the vocal cords, and a silent chest means complete obstruction. Initial treatment is to remove the trigger, perform jaw thrust and give oxygen with positive pressure. If this fails, a small dose of succinylcholine is used to relax the cords.

Option by option

  • A. Pass a suction catheter repeatedly deep into the pharynx

    Repeated deep suction provides more stimulation and can prolong the spasm.

  • B. Perform an immediate tracheostomy

    Tracheostomy is a last resort and is not the first step in a reversible reflex spasm.

  • C. Remove the stimulus, apply jaw thrust and give 100% oxygen with CPAP (correct)

    Correct. Removing the stimulus and supporting the airway with positive pressure often breaks the spasm.

  • D. Give neostigmine to reverse residual relaxant

    Neostigmine does not relieve reflex cord adduction and can worsen secretions.

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 C, Remove the stimulus, apply jaw thrust and give 100% oxygen with CPAP. This is laryngospasm, a reflex adduction of the vocal cords, and a silent chest means complete obstruction.

Why is "Pass a suction catheter repeatedly deep into the pharynx" not the answer?

Repeated deep suction provides more stimulation and can prolong the spasm.

Why is "Perform an immediate tracheostomy" not the answer?

Tracheostomy is a last resort and is not the first step in a reversible reflex spasm.

Why is "Give neostigmine to reverse residual relaxant" not the answer?

Neostigmine does not relieve reflex cord adduction and can worsen secretions.

What concept does this question test?

It tests Airway complications in Anaesthesia. Initial treatment is to remove the trigger, perform jaw thrust and give oxygen with positive pressure. If this fails, a small dose of succinylcholine is used to relax the cords.

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 Airway complications?

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.