Emergency medicine: ventilator weaning: practice question

A General Medicine 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 Medicine · Emergency medicine: ventilator weaning

Sample item

A ventilated patient after pneumonia is awake, haemodynamically stable with FiO2 of 0.4 and PEEP of 5. Which tool best predicts successful extubation?

AHeart rate aloneBSerum albuminCChest X-ray clearing aloneDA spontaneous breathing trial with rapid shallow breathing index below 105

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

The answer and the reasoning

D. A spontaneous breathing trial with rapid shallow breathing index below 105

Readiness for weaning is assessed by clinical criteria, then a spontaneous breathing trial of 30 to 120 minutes on low support. A rapid shallow breathing index (respiratory rate divided by tidal volume in litres) below 105 predicts success. Failure signs include tachypnoea, distress, desaturation and haemodynamic instability.

Option by option

A. Heart rate alone
Heart rate alone is not predictive.
B. Serum albumin
Albumin does not predict extubation success.
C. Chest X-ray clearing alone
Radiographic clearing alone is insufficient.
D. A spontaneous breathing trial with rapid shallow breathing index below 105 (correct)
Correct. SBT and RSBI guide weaning.

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 Medicine question

What is the answer to this General Medicine question?

The best answer is D, A spontaneous breathing trial with rapid shallow breathing index below 105. Readiness for weaning is assessed by clinical criteria, then a spontaneous breathing trial of 30 to 120 minutes on low support.

Why is "Heart rate alone" not the answer?

Heart rate alone is not predictive.

Why is "Serum albumin" not the answer?

Albumin does not predict extubation success.

Why is "Chest X-ray clearing alone" not the answer?

Radiographic clearing alone is insufficient.

What concept does this question test?

It tests Emergency medicine: ventilator weaning in General Medicine. A rapid shallow breathing index (respiratory rate divided by tidal volume in litres) below 105 predicts success. Failure signs include tachypnoea, distress, desaturation and haemodynamic instability.

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 Emergency medicine: ventilator weaning?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.