Obstructive Lung Disease

Front

A healthy patient presents on the day of an elective, non-urgent procedure with severe URI symptoms such as fever, purulent rhinitis, and productive cough. According to the COLDS assessment tool and anesthesia best practice, when should the patient undergo the elective surgery?

Back

Delay the elective case approximately 6 weeks.

Front

A 62 year old man with COPD is undergoing laparoscopic colectomy under general anesthesia on VCV. 30 minutes into the procedure, peak airway pressures rise, wheezing is heard, and capno shows an upsloping expiratory limb with progressively increasing EtCO2. No circuit/ETT kink, mucus plug, or mainstem intubation are detected, which ventilatory settings is the best next step to address this?

Back

decrease the RR to prolong expiratory time

Front

Which of the following pulmonary function test findings is most consistent with obstructive lung disease? FEV1/FVC ratio of 75%, FEV1 95% of predicted, FEV1/FVC ratio of 60%, DLCO 22 mL/min/mm H

Back

FEV1/FVC ratio of 60%

Front

Out of the listed spirometry results, which one correlated the most with obstructive lung disease and its characteristics? Options: Increased Inspiratory Reserve Volume, Unchanged Residual Volume, Increased FEV1/FVC ratio, Decreased FEV1/FVC ratio

Back

Decreased FEV1/FVC ratio

Front

A 65-year-old female smoker with severe COPD is coming in for thoracic surgery. The patient's records show FEV1/FVC <0.5 and PaCO₂ >50 mmHg. What postoperative strategy is best suited for this patient? Options: Extubate immediately to decrease ventilator dependence. Implement spirometry, chest physiology therapy, and titrate FiO2 for an SpO2 around 90%. Rapid correction of hypercarbia before induction. Use desflurane for faster emergence.

Back

Implement spirometry, chest physiology therapy, and titrate FiO2 for an SpO2 around 90%.

Front

Which pulmonary function test measures the diffusion of gases across the alveolar membrane? Options: FVC, MVV, FEV1/FVC Ratio, DLCO

Back

DLCO

Front

What is this patient's COLDS score for assessing perioperative risk?

Back

14

Front

A 68-year-old female with a long history of smoking comes to the clinic because of ongoing shortness of breath and daily cough with sputum. Her arterial blood gas on room air shows a PaO2 of 52 mm Hg and PaCO2 of 50 mm Hg, and her hematocrit is 56%. Based on current guidelines, which treatment would provide the greatest long-term survival benefit for this patient with COPD? Options: Long-term oxygen therapy, theophylline therapy, Administration of inhaled corticosteroids with antibiotic use, Long term Methylxanthines use

Back

Long-term oxygen therapy

Front

A 72-year-old female with known bronchiectasis is admitted with hemoptysis of 250 mL over the past 24 hours. What is the most appropriate next step in management? Options: Prepare for selective bronchial arterial embolization, Increase frequency of chest physiotherapy, Administer Guaifenesin 50 mg q4hr, Give platelets

Back

Prepare for selective bronchial arterial embolization

Front

A 16-year-old patient with a history of cystic fibrosis (CF) presents for an emergent laparoscopic appendectomy. The anesthetic plan of care includes general anesthesia with endotracheal intubation. Which medication should the CRNA avoid administering during this case? Options: Fentanyl, Rocuronium, Glycopyrrolate, Ondansetron

Back

Glycopyrrolate