Airway management: obstructing laryngeal tumour: 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: obstructing laryngeal tumour

Sample item

An elderly man with a bulky laryngeal tumour has inspiratory stridor at rest and needs an airway before biopsy. Which is the safest technique?

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

The answer and the reasoning

A. Awake tracheostomy under local anaesthesia

Stridor at rest signals a critically narrowed airway where loss of muscle tone can cause complete obstruction and failed mask ventilation. A tracheostomy under local anaesthesia secures the airway in the awake patient.

Option by option

  • A. Awake tracheostomy under local anaesthesia (correct)

    Correct. The airway is secured while the patient is awake and breathing.

  • B. Midazolam premedication followed by induction

    Sedation can precipitate complete obstruction.

  • C. Intravenous propofol and suxamethonium followed by laryngoscopy

    Paralysis can cause complete obstruction that cannot be bypassed.

  • D. Deep inhalational induction with a relaxant

    Deep induction removes tone and abolishes the protective patency.

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 A, Awake tracheostomy under local anaesthesia. Stridor at rest signals a critically narrowed airway where loss of muscle tone can cause complete obstruction and failed mask ventilation.

Why is "Midazolam premedication followed by induction" not the answer?

Sedation can precipitate complete obstruction.

Why is "Intravenous propofol and suxamethonium followed by laryngoscopy" not the answer?

Paralysis can cause complete obstruction that cannot be bypassed.

Why is "Deep inhalational induction with a relaxant" not the answer?

Deep induction removes tone and abolishes the protective patency.

What concept does this question test?

It tests Airway management: obstructing laryngeal tumour in Anaesthesia. A tracheostomy under local anaesthesia secures the airway in the awake patient.

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: obstructing laryngeal tumour?

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.