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Stay calm and intubate like a Pro :)

Total questions: 19

Worksheet time: 19mins

Name
Class
Date
1.

It’s 2 am in the morning and it is a busy shift at your RESUS with few of your staffs are on CK. You are the most experience doctor and you have attempted intubation x 3 for severe TBI patient but to no avail. What is the BEST next step in your intubation process?

a)

Continue BVM ventilation

b)

Call anesthetist

c)

Make a fourth attempt

d)

Insert a supraglottic device

2.

What is the best approach to ensure successful 1st past attempt in intubation

a)

Direct laryngoscope + bougie

b)

Glide scope

c)

CMAC + bougie

d)

Needle cricothyroidotomy

3.

The physiology behind adequate preoxygenation is

a)

To achieve SpO2 of >95%

b)

Denitrogenation

c)

To provide adequate PEEP

d)

To wash out CO2

4.

You are intubating a man with thick beard and moustache. What is the best technique to ensure good seal to ventilate him?

a)

Shave them

b)

Provide extra pressure during CE clamp

c)

Use a bigger mask

d)

Cover with plastic/tagederm

5.

A 32 years old gentleman with BMI of 38kg/m2 presented to you with Peritonsillar abscess (Quincy) and audible stridor. How will you choose your intubation technique?

a)

Awake intubation

b)

Needle crichothyroidotomy

c)

CMAC

d)

Rigid bronchoscope

6.

You are assessing a patient’s Mallampati score prior to intubation and you can see his soft palate and base of uvula. What is his Mallampati score?

a)

Malllampati I

b)

Mallampati II

c)

Mallampati III

d)

Mallampati IV

7.

It’s 3pm and you are taking over an intubated patient from your morning colleague. As you go through the case note, you saw CL 3 in the intubation clerking. What does that mean?

a)

Full view of glottis

b)

Neither glottis nor epiglottis is seen

c)

Partial view of glottis

d)

Only epiglottis is seen

8.

Which of this is not part of ‘LEMON’ mnemonic

a)

Mallampati score

b)

Neck mobility

c)

Elderly

d)

Obstruction

9.

You received a call from MECC telling you that they are transporting a 2 years old boy who was found drowning and still cyanosed despite initial oxygen support. Which of the options is peculiar to paediatric airway?

a)

Cylinder shape trachea

b)

Larynx is more anterior and cephalad

c)

Smaller tongue

d)

Flat occiput

10.

You are intubating a patient with BMI of 38kg/m2. As you are preparing a ramp, your junior MO asks you the physiology behind your approach. The best answer would be

a)

For patient comfort as no pillow is available

b)

To ensure proper BVM seal

c)

To increase the functional residual capacity

d)

To improve the glottis view by putting the patient in sniffing position

11.

All of bellow are the reasons why intubating a severe maxillofacial injury possess a great challenge except:

a)

Presence of obstruction

b)

Distorted axis

c)

No experience in performing front of neck airway

d)

Limited neck movement

12.

You have just successfully intubated a covid-19 patient. Which of the method below should you avoid when confirming your ETT placement?

a)

EtCO2

b)

Auscultation

c)

POCUS

d)

Equal chest rise

13.

As you are walking back home from your busy RESUS shift, your junior MO call you asking for your opinion in choosing the best paralytic agent for a 35 years old lady with BMI of 37kg/m2 and Mallampati score III with 77% TBSA burn injury.

a)

High dose succinylcholine

b)

High dose rocuronium

c)

Low dose rocuronium

d)

Low dose succinylcholine

14.

In what situation you will avoid using succinylcholine as your paralytic agent?

a)

ESRF patient

b)

A collapsed patient after joining a contest “Eat the most durian in 15mins”

c)

Peaked T wave in your 12 leads ECG

d)

Burn patient with 13% TBSA

15.

You are dealing with a severe TBI patient and had a difficulty to preoxygenate him as he is so restless. What is your best approach?

a)

Start your routine pretreatment and give paralytic agent

b)

Delayed sequence intubation using IV Ketamine

c)

Restrain him

d)

Apply nasal prong 15LO2 + HFM 15LO2

16.

Which of the following is not the physiologic killers in pre-intubation/peri-intubation process?

a)

BMI 35kg/m2

b)

Severe metabolic acidosis

c)

Hypotension

d)

Hypoxemia

17.

What is the contraindication for supraglottic devices?

a)

Cachexic

b)

No teeth

c)

Mallampati IV

d)

Restricted mouth opening

18.

It’s 4am in the morning and you are the most experience intubator in the department. A term pregnant lady rushed in by his husband in impending respiratory collapse and you failed your intubation and supraglottic device insertion. Which of the following should be your immediate step?

a)

Ventilate using BVM

b)

Front of neck airway

c)

Put patient under NIV

d)

Call up anesthetist

19.

Below are the challenges during intubating a term pregnant lady except:

a)

Airway oedema

b)

Limited drug of choice

c)

Aspiration risk

d)

Aortocaval compression