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WorksheetsReview Respiratory block
Total questions: 30
Worksheet time: 28mins
The normal vital capacity for a 70-kg man is
1 L
2 L
5 L
7 L
A 32- year -old man is found unconscious by the fire department in a room
where he has inhaled 0.1% carbon monoxide for a prolonged period. His
respiratory rate is 42 breaths/min, but he is not cyanotic. Carbon monoxide has
increased this patient’s minute ventilation by which of the following
mechanisms ?
Shifting the O2 hemoglobin dissociation curve to the left
Causing lactic acidosis
Decreasing Pao2
Increasing CO2 production
An acute increase in Paco2 of 10 mm Hg will result in a decrease in pH of
0.01 pH unit
0.02 pH unit
0.04 pH unit
0.08 pH unit
The P50 of sickle cell hemoglobin is
19 mm Hg
26 mm Hg
31 mm Hg
35 mmHg
The anatomic dead space in a 70-kg man is
50 ml
150 ml
250 ml
500 ml
Each of the following will shift the oxyhemoglobin dissociation curve to the
right EXCEPT
Volatile anesthetics
Decreased pH
Increased temperature
Decreased Pao2
The half -life of carboxyhemoglobin in a patient breathing 100% O2
is
4 hours
1 hour
5 minutes
2 hours
Which of the following factors could not explain a Pao2 of 48 mm Hg in a
patient breathing a mixture of nitrous oxide and oxygen?
Hypoxic gas mixture
Profound anemia
Hypercarbia
Eisenmenger syndrome
Maximizing which of the following lung parameters is the most important
factor in prevention of postoperative pulmonary complications ?
Vital capacity
Tidal volume (Vt)
Functional residual capacity (FRC)
Inspiratory reserve volume
Which of the following is one of the benefits regarding cessation of smoking 12 to 24 hours prior to surgery?
Shift of oxyhemoglobin dissociation curve to the right
Decrease in sputum production
Improvement in mucociliary transport
Improved small-airway function
The mode of ventilation which allows the patient to breathe spontaneously at his or her own respiratory rate and depth between the ventilator breaths is
Synchronous Intermittent Mandatory Ventilation
Assist Control Mode
Pressure Control Mode
Controlled Mandatory Ventilation
One of the following modes of ventilation reduces the work of breathing by overcoming the resistance created by ventilator tubing.
Assist Control Mode
Controlled Mandatory Ventilation
Pressure Support Mode
Synchronous Intermittent Mandatory Ventilation
Which of the following conditions require a higher PEEP to be applied in recruiting collapsed alveoli?
Bronchietasis
Emphysema
Acute Respiratory Distress Syndrome
Asthma
One of the following is a risk of keeping high PEEP
Hyperthermia
Hypotension
Hypothermia
Hypertension
Auto-PEEP may be reduced or eliminated by all of the following methods except:
Reducing the frequency
Increasing the expiratory time
Reducing the inspiratory flow
Reducing the VT
The ABG report of your patient on mechanical ventilation, is as follows: pH = 7.50, PaCO2 = 32 mm Hg, PaO2 = 83 mm Hg. You want to make appropriate changes to the settings on the ventilator. Which of the following controls would have the least impact in correcting the patient’s condition as indicated by the ABG results?
FiO2
Respiratory rate
Pressure support level
Tidal volume
Plateau pressure (Pplateau) is measured during which phase of the ventilatory cycle?
End-inspiration
End-expiration
Expiration
Inspiration
Cessation of smoking on the day prior to an operation is associated with a perioperative
decrease in sputum volume
decrease in carbon monoxide in blood
improvement in ciliary beating in the airways
decrease in the need for postoperative ventilatory support
Pulsus paradoxus is commonly seen during anesthesia in patients with each of the following conditions EXCEPT
hypovolemia
severe asthma
atrial septal defect
right-sided heart failure
A 16-year-old girl with asthma is to undergo routine pulmonary function testing. In order to measure the FEV1 during spirometry, she
forcefully exhales from total lung capacity to respiratory reserve volume
exhales forcefully from total lung capacity to residual volume
is asked to forcefully exhale for 1 second
is asked to breathe slowly at normal
tidal volumes
Which of the following is true regarding administering general anesthesia to a
chronic obstructive pulmonary disease (COPD) patient?
Use lower breathing rates to permit more exhalation time
Nitrous oxide + opioid technique is ideal
Correct the hypercapnia intraoperatively to help extubate early
Use large tidal volumes
A 55-year-old male presented to you with a pulmonary function test report, which
shows an increase of FEV1 percent predicted of more than 12%, and an increase in FEV1 of greater than 0.2 L in response to bronchodilators. Which characteristic of
his respiratory illness is depicted here?
Bronchial asthma acute bronchodilator responsiveness
COPD—acute bronchodilator responsiveness
Chronic obstructive pulmonary disease (COPD)—variability in airflow obstruction
All the above are correct
Drugs useful in the treatment of uterine atony in an asthmatic patient with
severe preeclampsia include
15-Methyl prostaglandin F2α
(PGF2α) (Carboprost, Hemabate)
only
Oxytocin (Pitocin) only
Ergonovine (Ergotrate) or methylergono vine (Methergine) only
All of the above are safe and can be used alone or in combination
with the others
A 33-year-old woman is admitted to the emergency department. She is known to have brittle asthma. She is admitted with an acute exacerbation; her peak flow is 40% of predicted and her pulse is 112 bpm. She has difficulty talking in sentences. Arterial blood gas shows a PaCO2
of 3.9kPa. She is given oxygen, nebulised salbutamol and ipratropium bromide, and intravenous hydrocortisone. There is, however, no improvement. The next step in
the subsequent management should be:
Intravenous magnesium sulphate
Nebulised adrenaline
Intravenous aminophylline
Arrange for non-invasive ventilation on intensive care
A 6-year-old child weighing 20kg is scheduled on a day-surgery list
for circumcision. He is mildly asthmatic and has had ibuprofen in the
past. His mother is quite worried about the postoperative pain.
Which one of the following is most likely to provide adequate pain
relief safely?
Penile block and regular paracetamol and ibuprofen.
Caudal block using 0.125% bupivacaine and ketamine 2mg/kg.
Caudal block using 10ml of 0.5% bupivacaine.
Regular ibuprofen and 4-hourly Oramorph for the first 24 hours.
Which of the following statements concerning lung transplantation is TRUE?
Hepatitis B and hepatitis C are not contraindications to lung transplantation.
The age limit for single-lung transplantation is 55 years.
Left-sided endobronchial double-lumen tubes are typically preferred for right as well as left transplants.
Diabetes and hypertension are contraindications to lung transplantation.
The results of pulmonary function tests performed on a patient
complaining of exertional breathlessness are as follows: FEV1 2.4L
(57% of predicted), FEV1/FVC ratio 0.8, DLCO reduced, DLCO/VA
reduced. [DLCO = Diffusion lung capacity for carbon monoxide; VA
= alveolar volume]. Which is the most likely diagnosis?
Pneumonectomy.
Asthma
Pulmonary haemorrhage.
Fibrosing alveolitis.
Which of the following can increase pulmonary vascular resistance?
Septicemia
Positive end-expiratory pressure (PEEP)
Systemic hypoxia
All of the above
Which of the following sympathomimetic drugs are β2 -selective and typically produce minimal cardiac effect from β1 -stimulation?
Metaproterenol
Epinephrine
Albuterol
Terbutaline
The first step recommended to improve oxygenation if a patient is exhibiting drop in Oxygen saturation during one-lung ventilation is
Apply continuous positive-airway pressure (CPAP) to the collapsed lung
Periodic inflation of the collapsed lung
Continuous inflation of oxygen into collapsed lung
Apply positive end–expiratory pressure (PEEP) to the dependent lung
