What is the maximum amount of air you can place in the bronchial cuff?

A 62-year-old man with moderate COPD is undergoing a right thoracotomy with OLV. The anesthesia team is using a left-sided DLT. During VCV of the dependent lung, the patient’s PIP rises to 42, plateau pressure is 24, and SpO2 is 92% on FiO2 50%. Which of the following is the most appropriate next step?

A patient with pulmonary hypertension is undergoing thoracic surgery. The anesthesiologist administers a CCB to control systemic hypertension. Soon after, the patient’s oxygenation decreases despite appropriate ventilatory settings. Which of the following mechanisms explains this change?

A 25-year-old patient with a history of cystic fibrosis presents for video-assisted thoracoscopy surgery to drain a localized abscess in the right lung. The anesthesiologist plans for OLV. Which of the following best explains the primary purpose of OLV in this patient?

In the lateral decubitus position during anesthesia, which of the following best describes the changes in V/Q relationship?

During OLV for a right thoracotomy, a patient develops significant hypoxemia (SpO2 85%). The ventilated lung is adequately oxygenated, tidal volume is low, PEEP is 5, and the Volatile concentration is 2 MAC. ABG shows mild hypocapnia. Which of the following could be contributing to impaired hypoxic pulmonary vasoconstriction in this scenario?

Which preop test is the most reliable predictor of postop pulmonary complications after lobectomy?

Why is RSI often performed for esophagectomy patients?

A 65-year-old male with COPD is scheduled for a right upper lobectomy. His spirometry shows FEV1 55% of predicted and his predicted postop DLCO is 28%. He walks one block before becoming dyspneic. Which of the following best describes his surgical risk?

A 72-year-old man with severe aortic stenosis (valve area 0.6, EF 55%) is scheduled for aortic valve replacement. Which intraoperative hemodynamic event is most dangerous for this patient?

During preop planning for cardiac surgery, you review a patient’s history of valve disease. Which valve lesion is MOST dependent on maintaining NSR for atrial kick to preserve CO?

Optimal HR in aortic regurg?

A 68-year-old man with CAD, hypertension, and T2DM is scheduled for CABG. His home meds include metoprolol, amlodipine, isosorbide, lisinopril, HCTZ, aspirin, and clopidogrel. Which of the following is the best preop medication management strategy?

During CABG, a BIS monitor is used to assess anesthetic depth. Which of the following BIS values is most consistent with adequate general anesthesia for surgery?

Which leads best detect intraop ischemia?

Which occurs first in acute ischemia?

A 72-year-old man is scheduled for CABG. During the preop evaluation, he reports chronic regurg of undigested food and halitosis. A barium swallow study shows a posterior outpouching of the esophageal mucosa at the level of the cricopharyngeal muscle. Which of the following best describes the significance of this finding for intraoperative management?

The mid-esophageal four-chamber view on the TEE primarily allows assessment of which of the following?

To obtain the transgastric midpapillary short-axis view, the probe is typically:

Which of the following is the most sensitive indicator of intraoperative MI during TEE?

The upper esophageal aortic arch short-axis view is primarily used to:

Protamine reverses heparin anticoagulation primarily by:

A 72 year-old man with severe AS (valve area 0.6, EF 55%) is scheduled for AVR.  Which intraoperative event is most dangerous?

During induction, a patient with acute aortic regurg is unstable. Which hemodynamic goal is best?

A patient undergoes TAVR with conscious sedation rather than GA. Which anesthesia advantage does this confer?

Which complication is more common in TAVR compared to surgical AVR?

Which beta-blocker strategy is most evidence-based for vascular surgery patients?

A 76-year-old undergoing CEA under GA becomes hypertensive/tachycardic during laryngoscopy. What is the most appropriate strategy?

After CEA, the patient has tongue deviation toward the operative side and dysarthria. Which nerve is injured?

During cross-clamp with GA and NIRS monitoring, rSO2 drops 22% from baseline. Best immediate action?

In a center favoring SACP with moderate hypothermia (26 C), left-sided NIRS falls 25% during unilateral ACP despite MAP 60 and Hct 24%. Best next step?

Open descending thoracic repair. Just prior to declamp, which is best?

Post-EVAR CT shows sac enlargement with contrast filling from lumbar arteries into the sac; graft seals are intact. Which endoleak is this?

Immediately after successful synchronized cardioversion, a patient in the EP lab becomes hypotensive with sinus rhythm on ECG. Which mechanism best explains this finding?

During a diagnostic EP study, arrhythmia induction fails repeatedly. The patient is deeply sedated on propofol 100 mcg/kg/min. Which change best facilitates arrhythmia induction?

During Watchman deployment, the patient becomes hypotensive with rising CVP. ECG unchanged. What is the next step?

During EBUS under GA, SpO2 drops from 98% to 84%. EtCO2 waveform dampens. The bronchoscopist is suctioning. First action?

A 62-year-old woman undergoing ION robotic bronchoscopy for a peripheral lung nodule is under GA with rocuronium paralysis. During mapping, the pulmonologist reports “registration drift” and asks if anything has changed. You note the anesthesia resident performed a recruitment maneuver and increased PEEP from 12 to 18 to treat desaturation. What is the best next step?