Respiratory physiology and ventilation: curriculum recognition: 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 · Respiratory physiology and ventilation: curriculum recognition

Sample item

Ten minutes after induction in a ventilated patient, the pulse oximeter, with a good trace, falls from 99 percent to 88 percent. What is the most appropriate first action?

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

The answer and the reasoning

C. Give 100 percent oxygen and check airway, circuit and ventilation

The first step in intraoperative hypoxaemia is to increase the oxygen fraction to 100 percent and then look for the cause, starting with the airway, tube position, circuit, ventilation and breath sounds. Investigations and other treatment follow once oxygenation is secure.

Option by option

  • A. Deepen anaesthesia with more volatile agent

    Deeper anaesthesia would not improve oxygenation and may worsen blood pressure.

  • B. Give a rapid bolus of intravenous fluid

    Fluid does not address the common causes of hypoxaemia such as tube or ventilation problems.

  • C. Give 100 percent oxygen and check airway, circuit and ventilation (correct)

    Correct. Treat first with oxygen, then work through the cause systematically.

  • D. Order a chest radiograph before intervening

    Imaging delays treatment of a falling saturation.

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, Give 100 percent oxygen and check airway, circuit and ventilation. The first step in intraoperative hypoxaemia is to increase the oxygen fraction to 100 percent and then look for the cause, starting with the airway, tube position, circuit, ventilation and breath sounds.

Why is "Deepen anaesthesia with more volatile agent" not the answer?

Deeper anaesthesia would not improve oxygenation and may worsen blood pressure.

Why is "Give a rapid bolus of intravenous fluid" not the answer?

Fluid does not address the common causes of hypoxaemia such as tube or ventilation problems.

Why is "Order a chest radiograph before intervening" not the answer?

Imaging delays treatment of a falling saturation.

What concept does this question test?

It tests Respiratory physiology and ventilation: curriculum recognition in Anaesthesia. Investigations and other treatment follow once oxygenation is secure.

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 Respiratory physiology and ventilation: curriculum recognition?

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.