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

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?

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?

Which of the following pulmonary function test findings is most consistent with obstructive lung disease?

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

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?

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

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?

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?

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?

A 16-year-old patient with a history of cystic fibrosis (CF) presents for an emergent laparoscopic appendectomy. The patient has thick pulmonary secretions and decreased breath sounds bilaterally. The anesthetic plan of care includes general anesthesia with endotracheal intubation. Which of the following medications should the CRNA avoid administering during this case?

A 45-year-old woman with a history of asthma is undergoing a laparoscopic hysterectomy under general anesthesia. Shortly after insufflation, the CRNA notices PIP 40, SpO2 85%, and up-sloping on the ETCO2 waveform. Which of the following interventions should the CRNA perform to treat a bronchospasm? (Select 3)

Which is NOT a classic presentation of COPD?

Which characteristic is the most common chronic medical condition in the world, characterized by bronchial hyperactivity and bronchoconstriction that is reversible?

A 48-year-old male presented to the pre-operative area for a THA. In the past two months he has states that he has become short of breath when walking his dog in the morning. He is a non-smoker. Upon further question, the patient admits that his wife of 10 years is a heavy smoker and smoke near him. He has a known familial history of Alpha-1 Antitrypsin deficiency. What differential diagnosis can be strongly considered in your Anesthesia Plan of Care?

What gas does the DLCO pulmonary function test utilize?

Your patient with severe COPD comes in for a laparoscopic appendectomy. The patient is sedated with general anesthesia and an endotracheal tube is placed. During the case, you notice that your peak & plateau pressures are rising and your waveform is not returning to baseline. What action(s) should you take? Select all that apply.

Which of the following is contraindicated in patients with asthma undergoing anesthesia due to risk of bronchospasm?

A 65-year-old man with severe COPD (FEV1/FVC ratio < 0.5, PaCO2 55 mmHg) is scheduled for an open abdominal surgery. Which of the following perioperative management strategies is most appropriate?

For a central airway obstruction, how would the flow volume loop present?

Your patient is a 16-year-old female that presents with an autosomal recessive disorder, with her sweat chloride levels at 78, and is coughing up thick, sticky secretions. Which of these interventions is least helpful to her anesthetic management?

A 62-year-old man with GOLD stage III COPD presents for an elective laparoscopic cholecystectomy. He continues to smoke and has dyspnea on exertion. Preop evaluation reveals FEV1 40% of predicted and PaCO₂ of 50. Which ventilation strategy is best to minimize hyperinflation and auto-PEEP?

What is the most common organism cultured in patients with bronchiectasis?

A 65-year-old female with a 10-year history of COPD (FEV1 45% predicted) presents for an elective inguinal hernia repair. She reports to using 2 pillows at night, dyspnea on exertion, chronic cough with sputum production, and frequent hospitalizations for exacerbations. Preoperative ABG on room air: pH 7.36, PaCO2 56 mmHg, PaO2 61mmHg, HCO3- 31. Her resting SpO2 is 92% on RA. Which of the following intraoperative management strategies is most appropriate for this patient?

During induction of anesthesia in a patient with a history of asthma, which of the following induction agents is most appropriate?

Your patient suddenly develops high peak airway pressures, wheezing, desaturation, and an upslope in ETCO₂ waveform during anesthesia. What is the most likely cause?

Which of the following drugs should be avoided in patients with asthma?

A 5-year-old girl comes in for her scheduled myringotomy surgery. During the preop exam you notice she is wheezing, has purulent green drainage out of her nose and having a hard time answering questions due to tachypnea. She has no other medical history. Which anesthetic plan is best for this situation?

Why do patients with asthma who are treated only with inhaled corticosteroids generally not require perioperative stress-dose steroid supplementation?

A 58-year-old man with a 40–pack-year smoking history is scheduled for elective hernia repair in 2 weeks. He quit smoking yesterday after being counseled by his surgeon. On preoperative evaluation, his carboxyhemoglobin levels are decreased, and his oxygen-carrying capacity has improved. Which of the following statements best reflects the clinical significance of his short-term smoking cessation?

Which are the signs of intraoperative bronchospasm? (select 3)

Select the preferable induction agent for an asthmatic patient who completed treatment for pneumonia one week ago.

You are preparing to perform anesthesia for an elective adrenotonsillectomy on a 9-year-old male. Upon examining him in pre-op, you gather the following data from your assessment: HR- 97, BP- 93/59, SpO2- 94% on RA, Temp: 38.2 °C, RR: 22. Physical examination reveals purulent nasal drainage and a productive cough. His mother states, "He's been dealing with this head cold for the past 5 days". Which of the following interventions would be most appropriate for the CRNA to take?

You are caring for a 65-year-old female with a history of severe asthma. Before surgery, she was given an albuterol breathing treatment. Post-treatment, her peak expiratory flow was greater than 80% predicted, she exhibited no wheezing on auscultation, and her oxygen saturation was 98% on room air. The patient progresses through the case with stable vital signs until she suddenly begins to desaturate to 79% on 35% FiO2. You notice elevated peak airway pressures (50 cm H2O) and an upsloping pattern on the ETCO2 monitor. All of the following interventions would be appropriate in this situation, EXCEPT:

A 45-year-old man with a history of asthma undergoes general anesthesia for an inguinal hernia repair. During the case, peak airway pressures suddenly rise, the capnography tracing shows an upsloping endtidal CO₂ waveform, and wheezing is heard on auscultation. Which of the following is the most appropriate initial management step?

A 32-year-old patient with a history of moderate persistent asthma presents for laparoscopic cholecystectomy. Which of the following induction agents is most appropriate to minimize the risk of bronchospasm?

Which pulmonary function test is within normal range?

This is the EtCO2 waveform of your patient with a history of asthma. What is the most likely cause of this waveform?

A 19-year-old patient with Asthma is going to have a Laparoscopic cholecystectomy. She uses her rescue inhaler twice daily for a week. On preop assessment you note mild expiratory wheezing. Which Drug would you want to avoid for this patient?

You have a patient who will be having a pulmonary function test. On your understanding of this you should know that all of the following are true except:

Which of the following pulmonary function test results is most characteristic of obstructive lung disease such as COPD?

A 64-year-old man with a 45-pack-year smoking history is scheduled for an open abdominal aortic aneurysm repair. His preoperative pulmonary function tests show FEV1/FVC ratio of 0.45, FEV1 at 45% predicted, and PaCO₂ of 55 mmHg. Which of the following intraoperative ventilation strategies is most appropriate for this patient?

Which of the following medications should be avoided or used cautiously in patients with asthma (Select 3)?

A 32-year-old male with cystic fibrosis presents for bronchoscopy due to persistent hemoptysis and worsening pulmonary function. He has a history of recurrent Pseudomonas infections and reports increased sputum production despite completing a recent course of antibiotics for pneumonia. On examination, he is afebrile, oxygen saturation is 93% on room air, and bilateral coarse crackles are noted on auscultation. Which of the following anesthetic management strategies is most appropriate to optimize intraoperative care for this patient?