EDAIC Respiratory and Thoracic Anesthesia 4

Question 1

During mediastinoscopy, the surgeon reports loss of the right radial pulse. The most likely cause is:

Accepted Answer

Compression of the innominate (brachiocephalic) artery by the mediastinoscope

Answer

The mediastinoscope can compress the innominate artery against the trachea, reducing right-sided perfusion; pulse oximetry on the right hand detects this before serious sequelae occur.

Question 2

Which statement about the use of PEEP during one-lung ventilation is TRUE?

Accepted Answer

PEEP on the ventilated lung reduces shunt by recruiting collapsed alveoli

Answer

Judicious PEEP (5 cmH2O) to the ventilated dependent lung recruits atelectatic alveoli and improves V/Q matching, though excessive PEEP can increase PVR and worsen hypoxemia.

Question 3

A fiberoptic bronchoscope confirms the right upper lobe bronchial orifice is blocked by the bronchial cuff of a right-sided double-lumen tube. The correct initial action is:

Accepted Answer

Deflate the bronchial cuff and withdraw the tube 1-2 cm

Answer

The right upper lobe bronchus originates close to the carina; partial withdrawal with cuff deflation allows the RUL orifice to align with the tube's ventilation slot.

Question 4

Hypoxic pulmonary vasoconstriction is blunted by all of the following EXCEPT:

Accepted Answer

Acidosis

Answer

Acidosis actually potentiates HPV rather than inhibiting it; vasodilators, hypothermia, and volatile agents at high concentrations are all recognized HPV inhibitors.

Question 5

Postoperative analgesia after VATS resection is MOST commonly managed with:

Accepted Answer

Paravertebral block

Answer

Paravertebral blocks provide unilateral segmental analgesia comparable to thoracic epidural analgesia with fewer side effects (hypotension, urinary retention) and are preferred for VATS procedures.

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 4