skip to main content

Endobronchial intubation — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGeneral AnaesthesiaEndobronchial intubationFRCA Final

A 49-year-old man is having laparoscopic cholecystectomy. Ten minutes after pneumoperitoneum, airway pressure rises from 18 to 38 cmH2O, capnography remains present, SpO2 falls to 91%, and auscultation reveals absent breath sounds on the left after the table is tilted head-up. What is the most likely cause of the complication?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Right main bronchial intubation after tube migration

Unilateral absent breath sounds after positioning with preserved capnography and high airway pressure most strongly suggests endobronchial migration of the tracheal tube. Bronchospasm would usually produce bilateral wheeze and an obstructive capnogram. Tension pneumothorax is possible during laparoscopy but would not be the commonest explanation after head-up movement and unilateral ventilation. Tube depth should be checked before escalating to more invasive diagnoses.

Reference: RCoA Final FRCA Syllabus 2026; Association of Anaesthetists monitoring standards