Airway management: capnograph with a notch in the plateau: 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: capnograph with a notch in the plateau

Sample item

In a ventilated patient on a relaxant infusion, the end-tidal CO2 waveform shows a dip in the plateau. What does this indicate?

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

The answer and the reasoning

A. Spontaneous respiratory effort as the block wears off

A cleft in the plateau, called a curare cleft, appears when the patient starts to breathe against the ventilator as the block fades. Oesophageal intubation gives a flat trace and bronchospasm a sloping shark-fin shape. An exhausted absorber raises the baseline.

Option by option

  • A. Spontaneous respiratory effort as the block wears off (correct)

    Correct. A curare cleft signals returning respiratory effort.

  • B. Exhaustion of the carbon dioxide absorber

    Absorber exhaustion raises the inspiratory baseline.

  • C. Bronchospasm

    Bronchospasm gives a shark-fin upstroke, not a notch.

  • D. Oesophageal intubation

    Oesophageal intubation gives no sustained waveform.

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, Spontaneous respiratory effort as the block wears off. A cleft in the plateau, called a curare cleft, appears when the patient starts to breathe against the ventilator as the block fades.

Why is "Exhaustion of the carbon dioxide absorber" not the answer?

Absorber exhaustion raises the inspiratory baseline.

Why is "Bronchospasm" not the answer?

Bronchospasm gives a shark-fin upstroke, not a notch.

Why is "Oesophageal intubation" not the answer?

Oesophageal intubation gives no sustained waveform.

What concept does this question test?

It tests Airway management: capnograph with a notch in the plateau in Anaesthesia. Oesophageal intubation gives a flat trace and bronchospasm a sloping shark-fin shape. An exhausted absorber raises the baseline.

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: capnograph with a notch in the plateau?

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.