Airway management: retrosternal goitre: 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: retrosternal goitre

Sample item

A 55-year-old with a long-standing goitre extending behind the sternum has positional dyspnoea and is listed for thyroidectomy. Which investigation best predicts airway difficulty?

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

The answer and the reasoning

C. CT scan of the neck and thorax

CT shows the size and extent of the goitre and the degree of tracheal deviation and narrowing, which guides the choice of tube, technique and need for awake intubation. Function tests, ultrasound and cytology answer other questions and do not define the airway.

Option by option

  • A. Thyroid ultrasound

    Ultrasound cannot image the retrosternal part or the trachea behind it.

  • B. Thyroid function tests

    Thyroid function tests show hormonal status, not airway anatomy.

  • C. CT scan of the neck and thorax (correct)

    Correct. It displays tracheal narrowing and displacement directly.

  • D. Fine needle aspiration cytology

    Cytology gives a diagnosis of the lump and says nothing of the airway.

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, CT scan of the neck and thorax. CT shows the size and extent of the goitre and the degree of tracheal deviation and narrowing, which guides the choice of tube, technique and need for awake intubation.

Why is "Thyroid ultrasound" not the answer?

Ultrasound cannot image the retrosternal part or the trachea behind it.

Why is "Thyroid function tests" not the answer?

Thyroid function tests show hormonal status, not airway anatomy.

Why is "Fine needle aspiration cytology" not the answer?

Cytology gives a diagnosis of the lump and says nothing of the airway.

What concept does this question test?

It tests Airway management: retrosternal goitre in Anaesthesia. Function tests, ultrasound and cytology answer other questions and do not define the airway.

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 management: retrosternal goitre?

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.