Obstructive Lung Disease

Which of the following are side effects of treating asthma with a beta 2 agonist (select 2)?

• Bradycardia

• Tremors

• Hypokalemia

• Dysarthria

• Hypocalcemia

Which of the following Spirometry data is correct? (select 2)

• FEV1/FVC 65% can be COPD

• FEV1/FVC 65% can be Asthma

• FEV1/FVC > 80% can be Emphysema

• FEV1/FVC > 80% can be Chronic Bronchitis

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?

• Proceed as scheduled with an LMA and deep extubation to reduce airway stimulation

• Delay surgery by 1 week

• Delay 24-48 hours after symptoms improve

• Delay the elective case approximately 6 weeks.

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?

• decrease the RR to prolong expiratory time

• Increase RR to 20 to “blow off” CO2 quicker.

• Increase PEEP from 8 to 12 cm H2O.

• Switch to desflurane to enhance bronchodilation.

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

Out of the listed spirometry results, which one correlated the most with obstructive lung disease and its characteristics?

• Increased Inspiratory Reserve Volume

• Unchanged Residual Volume

• Increased FEV1/FVC ratio

• Decreased FEV1/FVC ratio

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, for a better patient outcome and COPD-specific anesthesia plan. What postoperative strategy is best suited for this patient?

• 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.

Which pulmonary function test measures the diffusion of gases across the alveolar membrane?

• FVC

• MVV

• FEV1/FVC Ratio

• DLCO

A 58 year old male patient presents in preop for total knee arthroplasty. Patient reports rhinorrhea that started 4 days ago. Patient does not have asthma or any previous respiratory history. Anesthesia plan is general anesthesia with an ETT. What is this patient's COLDS score for assessing perioperative risk?

• 5

• 11

• 14

• 25

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?

• Long-term oxygen therapy

• theophylline therapy

• Administration of inhaled corticosteroids with antibiotic use

• Long term Methylxanthines use