Airway Management (Difficult Airway, Intubation, Airway Devices) MCQs

Anaesthesia · 38 free questions with answers & explanations.

1. During direct laryngoscopy using a Macintosh blade, the tip of the blade is placed into the vallecula (between epiglottis and base of tongue) to indirectly elevate the epiglottis via which ligament?
2. According to the Difficult Airway Society (DAS) 2015 guidelines, after two failed intubation attempts in a 'can't intubate, can't oxygenate' (CICO) scenario with a second-generation supraglottic airway also failing to maintain oxygenation, the immediate next step is:
3. The Cormack-Lehane grading system classifies laryngoscopic views. A Grade 3 view corresponds to:
4. A Proseal LMA (PLMA) compared to a Classic LMA (CLMA) has an additional advantage in the anaesthetic management of laparoscopic surgery because it:
5. BURP (Backward, Upward, Rightward Pressure) manoeuvre is applied during direct laryngoscopy. Which structure is being externally manipulated to improve the laryngoscopic view?
6. In the ASA Difficult Airway Algorithm, the 'cannot intubate, cannot oxygenate' (CICO) emergency pathway mandates which immediate intervention as the primary surgical airway strategy?
7. A video-laryngoscope (VL) improves the view of the glottis compared to direct laryngoscopy. However, improved view does not always translate to successful intubation with a VL. What is the most common reason for this discrepancy?
8. An i-gel supraglottic airway is preferred over classic LMA for second-generation airway devices because it offers which key additional feature?
9. The Cormack-Lehane (CL) classification grades laryngoscopic view. A grade 3 view (only the epiglottis visible, no glottis seen) is best managed by which intubation adjunct as first choice?
10. BURP (Backward, Upward, Rightward Pressure) manoeuvre applied to the thyroid cartilage during laryngoscopy aims to achieve which specific effect?
11. Following failed direct laryngoscopy (Cormack-Lehane grade 4) in a non-fasted patient, oxygenation is maintained by face mask. According to the NAP4 / Difficult Airway Society 2015 guidelines, what is the NEXT appropriate step?
12. The Intubating Laryngeal Mask Airway (ILMA/LMA Fastrach) differs from the classic LMA in which important design feature that facilitates blind or scope-guided tracheal intubation through it?
13. Videolaryngoscopy (McGrath/C-MAC) consistently provides better glottic views than direct laryngoscopy. Despite a Grade 1 Cormack-Lehane view on video, intubation fails. What is the most common reason for this paradox?
14. In predicting difficult airway, the LEMON score is used. A patient with a Mallampati score of III, thyromental distance of 5 cm, inter-incisor gap of 3 cm, and no neck mobility restriction has which LEMON components contributing to difficulty?
15. Awake fibreoptic intubation (AFOI) is planned for a morbidly obese patient with a large goitre causing tracheal deviation. Which topical anaesthesia technique provides the best anaesthesia of the supraglottic larynx and vocal cords?
16. According to the ASA Difficult Airway Algorithm, if a patient is classified as 'cannot intubate, cannot oxygenate' (CICO) and all attempts at supraglottic oxygenation have failed, the DEFINITIVE next step is:
17. The STOP-Bang score is used perioperatively to screen for obstructive sleep apnoea (OSA). A patient with a score of 5 is considered high risk. In the anaesthetic management of such a patient, postoperative opioid use should be minimised because:
18. A Cormack-Lehane grade 3 view is obtained at direct laryngoscopy. The MOST effective single manoeuvre to improve the laryngoscopic view to grade 1 or 2 is:
19. Second-generation supraglottic airway devices (e.g., ProSeal LMA, i-gel) differ from first-generation devices primarily in:
20. In a patient with an unstable cervical spine injury requiring emergency intubation, in-line manual cervical stabilisation (MILS) is applied by an assistant. Compared with intubation without MILS, this manoeuvre is known to:
21. After failed intubation in a 'cannot intubate, can oxygenate' scenario during RSI, the anaesthetist has placed an LMA Supreme and ventilation is adequate. According to the DAS 2015 guidelines, the next priority step is:
22. An obese patient (BMI 48) undergoing laparoscopic sleeve gastrectomy has Cormack-Lehane grade 3 laryngoscopy view. The anaesthetist uses a videolaryngoscope with a hyperangulated blade (CMAC D-Blade). Even though the glottis is now visible, tube delivery is difficult. The most appropriate next manoeuvre is:
23. During awake fibreoptic intubation, topical airway anaesthesia is being applied. Benzocaine spray used on the oro- and hypopharyngeal mucosa can cause a serious complication. Which finding on pulse oximetry would alert the anaesthetist to this complication?
24. The ARDS-defining P/F ratio cannot be calculated intraoperatively. The SpO2/FiO2 (S/F ratio) is used as a surrogate. An S/F ratio of 214 most closely corresponds to a P/F ratio of approximately:
25. A failed intubation occurs in an obese parturient after two attempts. SpO2 is 94% and falling. Ventilation with a bag-mask is adequate. According to the Difficult Airway Society (DAS) Obstetric Airway Guidelines, the NEXT step after declaration of failed intubation (Plan C) with adequate bag-mask ventilation is:
26. The Cormack-Lehane (C-L) grading classifies laryngoscopic view. A grade III view (only the epiglottis visible, no glottis seen) is obtained on direct laryngoscopy. The BEST device to improve visualisation and achieve successful intubation is:
27. A patient who is impossible to mask ventilate and impossible to intubate (CICO scenario) after full RSI doses. The 'last resort' surgical airway is required. What is the FIRST-LINE method for emergency surgical airway in adults?
28. A laryngeal mask airway (LMA) Classic size 4 is inserted in an 65 kg adult patient for an elective laparoscopic cholecystectomy. What is the MOST important reason why a classic LMA is considered unsuitable (and an ETT or ProSeal LMA preferred) for laparoscopic procedures?
29. In a 'cannot intubate, cannot oxygenate' (CICO) emergency scenario, which is the DEFINITIVE rescue technique according to the DAS (Difficult Airway Society) guidelines?
30. The ProSeal LMA (PLMA) differs from classic LMA in several design features. Which feature of the PLMA specifically reduces the risk of pulmonary aspiration?
31. A modified Cormack-Lehane grade 3 view (epiglottis visible, no vocal cords seen) is obtained on direct laryngoscopy. Which adjunct is MOST likely to facilitate successful intubation as the next manoeuvre?
32. During direct laryngoscopy for orotracheal intubation, the Cormack–Lehane grade III view is defined as:
33. A 30-year-old patient with a known difficult airway is scheduled for elective neck surgery. Pre-oxygenation is followed by awake fibreoptic nasotracheal intubation. The drug of choice for topical anaesthesia of the airway for this procedure is:
34. A supraglottic airway device (LMA Classic) is inserted successfully. The device does NOT reliably protect against which of the following?
35. Following failed intubation in a 'cannot intubate, cannot oxygenate' (CICO) scenario, the FIRST priority emergency surgical airway intervention is:
36. Rapid sequence induction (RSI) is indicated for a patient with a full stomach. The sequence includes pre-oxygenation, cricoid pressure (Sellick manoeuvre), induction agent, and succinylcholine. The purpose of cricoid pressure is to:
37. A 'cannot intubate, cannot oxygenate' (CICO) scenario has developed. The anaesthetist attempts an emergency front-of-neck airway (eFONA). Which technique is currently preferred by DAS 2015 guidelines for the first attempt?
38. Pre-oxygenation with tidal-volume breathing of 100% O2 for 3 minutes extends safe apnoea time. In a morbidly obese patient (BMI 48 kg/m2), what modification to pre-oxygenation technique is recommended to further extend this safe apnoea window?