Burns: inhalation injury: practice question

A General Surgery 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.

Try it

General Surgery · Burns: inhalation injury

Sample item

A 30-year-old man is rescued from a house fire in an enclosed room with burns to the face and neck. He has a hoarse voice, singed nasal hair and soot in the oropharynx, but is currently speaking and his saturation is 96%. What is the most appropriate management?

AObservation for 24 hours before deciding on an airwayBChest radiograph and intubate only if it is abnormalCEarly endotracheal intubation before oedema developsDNebulised steroids alone

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

The answer and the reasoning

C. Early endotracheal intubation before oedema develops

Hoarseness, singed nasal hair, facial burns and oropharyngeal soot indicate probable inhalation injury, in which airway oedema progresses rapidly, especially after fluid resuscitation. Early intubation by an experienced operator is safer than a late emergency attempt through a swollen airway. Chest radiographs are often normal initially.

Option by option

A. Observation for 24 hours before deciding on an airway
Waiting risks complete obstruction when intubation becomes impossible.
B. Chest radiograph and intubate only if it is abnormal
The radiograph is frequently normal early and cannot exclude airway injury.
C. Early endotracheal intubation before oedema develops (correct)
Correct. Securing the airway early prevents obstruction as oedema peaks.
D. Nebulised steroids alone
Steroids have no proven benefit in inhalation injury and do not secure the airway.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Early endotracheal intubation before oedema develops. Hoarseness, singed nasal hair, facial burns and oropharyngeal soot indicate probable inhalation injury, in which airway oedema progresses rapidly, especially after fluid resuscitation.

Why is "Observation for 24 hours before deciding on an airway" not the answer?

Waiting risks complete obstruction when intubation becomes impossible.

Why is "Chest radiograph and intubate only if it is abnormal" not the answer?

The radiograph is frequently normal early and cannot exclude airway injury.

Why is "Nebulised steroids alone" not the answer?

Steroids have no proven benefit in inhalation injury and do not secure the airway.

What concept does this question test?

It tests Burns: inhalation injury in General Surgery. Early intubation by an experienced operator is safer than a late emergency attempt through a swollen airway. Chest radiographs are often normal initially.

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 Burns: inhalation injury?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.