EDAIC Respiratory and Thoracic Anesthesia 2

Question 1

During one-lung ventilation (OLV), which mechanism is primarily responsible for hypoxic pulmonary vasoconstriction (HPV) in the non-ventilated lung?

Accepted Answer

Decreased alveolar O2 tension

Answer

HPV is triggered by low alveolar PO2 in the non-ventilated lung, causing vasoconstriction that diverts blood toward the ventilated lung and reduces intrapulmonary shunt.

Question 2

A patient undergoing right pneumonectomy develops sudden hypotension and elevated CVP immediately after lung removal. The most likely cause is:

Accepted Answer

Acute right ventricular failure due to increased pulmonary vascular resistance

Answer

After pneumonectomy, the entire cardiac output passes through the remaining lung, dramatically increasing PVR and precipitating acute RV failure.

Question 3

Which inhalational agent has the LEAST inhibitory effect on hypoxic pulmonary vasoconstriction at clinically used concentrations?

Accepted Answer

Nitrous oxide

Answer

Nitrous oxide has minimal direct effect on HPV compared to the volatile halogenated agents, though it is rarely used alone in thoracic surgery.

Question 4

The recommended tidal volume during one-lung ventilation to minimize ventilator-induced lung injury is:

Accepted Answer

5-6 mL/kg IBW

Answer

Current lung-protective OLV strategy uses tidal volumes of 5-6 mL/kg ideal body weight to prevent overdistension of the ventilated lung.

Question 5

When positioning a double-lumen tube (DLT) for left-sided surgery, which side should the bronchial lumen be inserted into?

Accepted Answer

Left bronchus always

Answer

A left-sided DLT is preferred for most thoracic cases because the right upper lobe bronchus is easily blocked; for left pneumonectomy a right-sided DLT or bronchial blocker is used instead.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Respiratory and Thoracic Anesthesia 2