Juli M26 BEDAH KARDIOTHORAKSIS DASAR - dr. PP

1. During one-lung ventilation (OLV), which of the following techniques is most effective in improving oxygenation when hypoxemia occurs despite optimal ventilation settings?

• A. Increasing tidal volume on the ventilated lung
• B. Applying continuous positive airway pressure (CPAP) to the non-ventilated lung
• C. Adding positive end-expiratory pressure (PEEP) to the non-ventilated lung
• D. Switching to total intravenous anesthesia (TIVA)

2. Which of the following is the most critical preoperative concern when providing anesthesia for a patient with a large anterior mediastinal mass?

• A. Potential airway obstruction
• B. Postoperative pain management
• C. Risk of aspiration
• D. Hypothermia during surgery

3. Which of the following is a key consideration when selecting anesthetic techniques for thoracic surgery?

• A. Avoiding muscle relaxation to preserve spontaneous breathing
• B. Ensuring the ability to perform one-lung ventilation (OLV)
• C. Using only regional anesthesia for all thoracic surgeries
• D. Administering high-dose opioids as the sole method of analgesia

4. Which of the following is the most important consideration when administering anesthesia to a patient with myasthenia gravis?

• A. Avoiding all neuromuscular blocking agents
• B. Using high doses of neuromuscular blocking agents to overcome resistance
• C. Anticipating prolonged respiratory depression and planning for postoperative ventilation
• D. Administering anticholinesterase inhibitors immediately before induction

5. In the anesthetic management of a patient with pulmonary hypertension (PH), which of the following intraoperative interventions is most appropriate to reduce the risk of acute right ventricular (RV) failure?

• A. Administering high doses of vasoconstrictors to maintain systemic blood pressure
• B. Avoiding hypercarbia and hypoxia to reduce pulmonary vascular resistance (PVR)
• C. Using large fluid boluses to optimize preload and prevent hypotension
• D. Relying solely on inhaled anesthetics for myocardial protection

6. Which of the following is the most effective strategy to prevent postoperative pulmonary complications (PPCs) in a thoracic surgery patient?

• A. Routine use of high-dose opioids for pain management
• B. Early extubation and pulmonary physiotherapy
• C. Prolonged bed rest to avoid strain on the surgical site
• D. Administering prophylactic antibiotics for all patients

7. Which postoperative complication is most likely in a patient following a pneumonectomy, and how should it be managed?

• A. Tension pneumothorax; treat with immediate needle decompression
• B. Bronchopleural fistula; manage with chest tube drainage and possible surgical repair
• C. Pulmonary embolism; treat with bronchodilators and antibiotics
• D. Acute respiratory distress syndrome (ARDS); manage with aggressive fluid administration

8. Which of the following pain management techniques provides the most effective combination of analgesia and preservation of respiratory function after thoracic surgery?

• A. Systemic opioids via patient-controlled analgesia (PCA)
• B. Epidural analgesia with a combination of local anesthetics and opioids
• C. Intercostal nerve block with a single injection of local anesthetic
• D. Continuous intravenous ketamine infusion as the sole analgesic

9. Which of the following best describes the primary mechanism of hypoxic pulmonary vasoconstriction (HPV)?

• A. Increased release of nitric oxide (NO) by pulmonary endothelial cells
• B. Constriction of pulmonary arterioles in response to alveolar hypoxia
• C. Activation of systemic vasodilation pathways to improve oxygen delivery
• D. Recruitment of additional pulmonary capillaries to enhance ventilation-perfusion matching

10. Which of the following is the most important perioperative management strategy to reduce the risk of postoperative complications in patients undergoing thoracic surgery?

• A. Prolonged preoperative fasting to reduce the risk of aspiration
• B. Maintaining normocapnia during anesthesia to prevent pulmonary vasoconstriction
• C. Avoiding the use of muscle relaxants to preserve spontaneous breathing
• D. Administering high doses of intravenous fluids to optimize preload