Airway management: tracheal stenosis after intubation: 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 management: tracheal stenosis after intubation

Sample item

A 40-year-old develops progressive exertional dyspnoea and stridor six weeks after a three-week stay in intensive care with a tracheal tube. The flow-volume loop shows a fixed plateau. What is the most likely cause?

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

The answer and the reasoning

C. Tracheal stenosis from cuff-induced ischaemia

High cuff pressures cause mucosal ischaemia, ulceration and fibrosis, producing a fixed stenosis weeks after extubation. Cuff pressure is kept at about 20 to 30 cm of water. Management includes bronchoscopic dilatation, stenting or resection.

Option by option

  • A. Bilateral recurrent laryngeal nerve palsy

    Nerve palsy would produce voice change and a variable pattern, not a delayed fixed obstruction.

  • B. Vocal cord polyps from voice abuse

    Polyps would not follow the time course of ICU intubation.

  • C. Tracheal stenosis from cuff-induced ischaemia (correct)

    Correct. Post-intubation tracheal stenosis presents weeks later with stridor and a fixed obstruction.

  • D. Recurrent episodes of laryngospasm

    Laryngospasm is acute and transient, not progressive over weeks.

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, Tracheal stenosis from cuff-induced ischaemia. High cuff pressures cause mucosal ischaemia, ulceration and fibrosis, producing a fixed stenosis weeks after extubation.

Why is "Bilateral recurrent laryngeal nerve palsy" not the answer?

Nerve palsy would produce voice change and a variable pattern, not a delayed fixed obstruction.

Why is "Vocal cord polyps from voice abuse" not the answer?

Polyps would not follow the time course of ICU intubation.

Why is "Recurrent episodes of laryngospasm" not the answer?

Laryngospasm is acute and transient, not progressive over weeks.

What concept does this question test?

It tests Airway management: tracheal stenosis after intubation in Anaesthesia. Cuff pressure is kept at about 20 to 30 cm of water. Management includes bronchoscopic dilatation, stenting or resection.

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 Airway management: tracheal stenosis after intubation?

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.