EDAIC Respiratory and Thoracic Anesthesia 5

Question 1

During thoracic surgery in the lateral decubitus position, the dependent lung has INCREASED perfusion because of:

Accepted Answer

Gravity-dependent redistribution of pulmonary blood flow

Answer

Gravity directs more blood flow to the dependent (down) lung in the lateral position, creating the basis for matched ventilation and perfusion during two-lung ventilation.

Question 2

A 45-year-old woman scheduled for left VATS lobectomy has a predicted postoperative FEV1 of 52% and DLCO of 55%. According to ESTS guidelines, her surgical risk category is:

Accepted Answer

Low risk — no further testing required

Answer

Both predicted postoperative FEV1 and DLCO >40% place the patient in the low-risk category, and surgery may proceed without mandatory CPET.

Question 3

Which of the following most accurately describes the physiological effect of opening the chest during thoracotomy on the non-paralyzed patient breathing spontaneously?

Accepted Answer

Paradoxical movement of the operative lung causing mediastinal swing

Answer

In the awake spontaneously breathing patient, opening the chest causes the operative lung to collapse on inspiration and expand on expiration (paradoxical), with the mediastinum shifting toward the closed side.

Question 4

Which drug should be AVOIDED when treating HPV inhibition-related hypoxemia during OLV?

Accepted Answer

IV nitroglycerin

Answer

Nitroglycerin is a pulmonary vasodilator that inhibits HPV systemically, worsening hypoxemia by increasing blood flow to the non-ventilated lung.

Question 5

The 'difficult airway' encountered during planned fiberoptic intubation for thoracic surgery is best managed by which backup strategy according to the DAS guidelines?

Accepted Answer

Supraglottic airway (LMA) insertion followed by fiber-optic intubation through it

Answer

DAS guidelines recommend a second-generation supraglottic airway as a rescue device; fiberoptic intubation through the LMA can then establish a definitive airway.

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 5