Airway management: rapid sequence induction: 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: rapid sequence induction

Sample item

Which neuromuscular blocker and dose provides intubating conditions comparable to suxamethonium in a rapid sequence induction?

AAtracurium 0.1 mg/kgBRocuronium 1.0 to 1.2 mg/kgCVecuronium 0.05 mg/kgDPancuronium 0.02 mg/kg

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

The answer and the reasoning

B. Rocuronium 1.0 to 1.2 mg/kg

High-dose rocuronium of 1.0 to 1.2 mg/kg gives intubating conditions in about 60 seconds and can be reversed with sugammadex. It is the usual alternative when suxamethonium is contraindicated.

Option by option

A. Atracurium 0.1 mg/kg
Atracurium at that dose is slow and not suited for RSI.
B. Rocuronium 1.0 to 1.2 mg/kg (correct)
Correct. High-dose rocuronium acts rapidly enough.
C. Vecuronium 0.05 mg/kg
Vecuronium at low dose has a slow onset.
D. Pancuronium 0.02 mg/kg
Pancuronium has slow onset and long duration.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Rocuronium 1.0 to 1.2 mg/kg. High-dose rocuronium of 1.

Why is "Atracurium 0.1 mg/kg" not the answer?

Atracurium at that dose is slow and not suited for RSI.

Why is "Vecuronium 0.05 mg/kg" not the answer?

Vecuronium at low dose has a slow onset.

Why is "Pancuronium 0.02 mg/kg" not the answer?

Pancuronium has slow onset and long duration.

What concept does this question test?

It tests Airway management: rapid sequence induction in Anaesthesia. 0 to 1.2 mg/kg gives intubating conditions in about 60 seconds and can be reversed with sugammadex. It is the usual alternative when suxamethonium is contraindicated.

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: rapid sequence induction?

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.