Larynx and airway: percutaneous tracheostomy: practice question

A ENT 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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ENT · Larynx and airway: percutaneous tracheostomy

Sample item

In which setting is percutaneous dilatational tracheostomy most commonly performed?

AIn an infant with a short neckBIn a patient with an unstable cervical spine fracture and bleeding disorderCBedside in an intensive care patient with a normal neck anatomyDIn a patient with a large goitre

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

The answer and the reasoning

C. Bedside in an intensive care patient with a normal neck anatomy

Percutaneous tracheostomy uses a needle, guidewire and sequential dilators under bronchoscopic guidance, and is widely used in ICU patients needing prolonged ventilation. It is relatively contraindicated in children, coagulopathy, obscured landmarks or neck masses. It is quicker and has fewer wound infections than open tracheostomy.

Option by option

A. In an infant with a short neck
Infants are usually done by open technique.
B. In a patient with an unstable cervical spine fracture and bleeding disorder
Coagulopathy and spinal instability are relative contraindications.
C. Bedside in an intensive care patient with a normal neck anatomy (correct)
Correct. Standard ICU use in adults with good landmarks.
D. In a patient with a large goitre
A goitre obscures anatomy and favours an open approach.

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.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Bedside in an intensive care patient with a normal neck anatomy. Percutaneous tracheostomy uses a needle, guidewire and sequential dilators under bronchoscopic guidance, and is widely used in ICU patients needing prolonged ventilation.

Why is "In an infant with a short neck" not the answer?

Infants are usually done by open technique.

Why is "In a patient with an unstable cervical spine fracture and bleeding di…" not the answer?

Coagulopathy and spinal instability are relative contraindications.

Why is "In a patient with a large goitre" not the answer?

A goitre obscures anatomy and favours an open approach.

What concept does this question test?

It tests Larynx and airway: percutaneous tracheostomy in ENT. It is relatively contraindicated in children, coagulopathy, obscured landmarks or neck masses. It is quicker and has fewer wound infections than open tracheostomy.

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 Larynx and airway: percutaneous tracheostomy?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.