Airway assessment: rheumatoid arthritis: 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 assessment: rheumatoid arthritis

Sample item

A patient with long-standing rheumatoid arthritis is to have general anaesthesia. Which preoperative airway assessment is most important?

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

The answer and the reasoning

A. Lateral cervical spine radiographs in flexion and extension

Rheumatoid arthritis can cause atlantoaxial subluxation, and neck extension during laryngoscopy may then damage the cervical cord. Dynamic cervical radiographs identify instability. Cricoarytenoid arthritis and temporomandibular joint involvement can add to airway difficulty.

Option by option

  • A. Lateral cervical spine radiographs in flexion and extension (correct)

    Correct. Dynamic films detect atlantoaxial instability before laryngoscopy.

  • B. Serum rheumatoid factor titre

    Rheumatoid factor does not guide airway management.

  • C. Measurement of grip strength

    Grip strength is not related to airway risk.

  • D. Chest radiograph for the lung bases only

    A chest film does not assess neck stability.

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, Lateral cervical spine radiographs in flexion and extension. Rheumatoid arthritis can cause atlantoaxial subluxation, and neck extension during laryngoscopy may then damage the cervical cord.

Why is "Serum rheumatoid factor titre" not the answer?

Rheumatoid factor does not guide airway management.

Why is "Measurement of grip strength" not the answer?

Grip strength is not related to airway risk.

Why is "Chest radiograph for the lung bases only" not the answer?

A chest film does not assess neck stability.

What concept does this question test?

It tests Airway assessment: rheumatoid arthritis in Anaesthesia. Dynamic cervical radiographs identify instability. Cricoarytenoid arthritis and temporomandibular joint involvement can add to airway difficulty.

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 assessment: rheumatoid arthritis?

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.