Thoracic Anesthesia

A patient with a tumor located in the anterior mediastinum is scheduled for surgery. What is the primary anesthetic concern regarding this tumor's location?

During a mediastinoscopy, which anatomical structures are at greatest risk of injury, leading to significant complications?

The right mainstem bronchus has a larger diameter and a 25-degree angle of take-off from the trachea, whereas the left mainstem bronchus has a smaller diameter and a 45-degree angle of take-off. During intubation with a standard ETT, why is there is a risk of mainstem intubation?

What is the most critical factor in optimizing survival rates for patients diagnosed with lung cancer?

A patient presents with a lung tumor and is subsequently diagnosed with Small Cell Lung Cancer (SCLC). Which of the following characteristics is LEAST likely to be associated with this type of lung cancer?

A patient is diagnosed with Large Cell Lung Cancer. Which of the following characteristics is most consistent with this diagnosis?

A patient presents with a lung tumor located at the apex of the lung, invading the brachial plexus and causing shoulder pain. Which type of lung cancer is most likely associated with this presentation?

Which of the following scenarios best illustrates the typical progression and characteristics of squamous cell carcinoma of the lung?

A patient with a history of heavy smoking is diagnosed with a centrally located lung tumor obstructing the mainstem bronchus. Which of the following complications is LEAST likely to be directly caused by the tumor's location and characteristics?

A patient is found to have a firm, marble-like tumor in the periphery of their lung, composed of normal tissue elements. Which of the following is the most likely diagnosis?

Which paraneoplastic syndrome is frequently observed in Small Cell Lung Cancer (SCLC) due to release of ADH from tumor?

A patient with small cell lung cancer presents with euvolemic hypo-osmolar hyponatremia. Which paraneoplastic syndrome is most likely the cause?

A patient with a history of squamous cell carcinoma develops hypercalcemia. Which mechanism is the most likely cause of this electrolyte imbalance?

A patient presents with miosis, ptosis, and anhidrosis on the right side of their face, along with shoulder pain. Imaging reveals a mass in the apex of the right lung. Which condition is most likely causing these signs and symptoms?

Which of the following anesthetic considerations is most critical for a patient diagnosed with Lambert-Eaton Myasthenic Syndrome (LEMS) secondary to lung cancer? select 2

What is the primary physiological consequence of chronic hypoxemia in COPD patients that leads to right ventricular dysfunction?

A patient with lung cancer develops Superior Vena Cava (SVC) syndrome. Which of the following clinical signs would be observed?

A patient with severe COPD is scheduled for a lung resection. Preoperative assessment reveals a significantly reduced FEV1. Which additional measurement would be MOST important in predicting postoperative respiratory complications?

A patient with a history of COPD is scheduled for a surgical procedure. Which of the following intraoperative ventilator strategies should be used with caution? select 3

Which of the following signs or symptoms is associated with lung cancer?

Which of the following best describes the utility of the 'reversibility test' in the context of FEV1 measurement for COPD patients?

What is the rationale behind avoiding nitrous oxide (N2O) in patients with significant bullous emphysema undergoing mechanical ventilation?

Which of the following paraneoplastic syndromes is associated with ectopic release of ACTH, leading to symptoms such as moon face, buffalo hump, and hypokalemia?

A patient with a carcinoid tumor experiences intraoperative hemodynamic instability and coronary artery spasm. Which of the following substances is most likely implicated in this crisis?

A patient presents with migratory thrombophlebitis. Which of the following conditions is most likely associated with this finding?

A patient is scheduled to undergo a major oncologic resection. Preoperative evaluation reveals usage of bleomycin and mitomycin. What specific perioperative concern should be anticipated in this patient?

During a left-sided thoracoscopy with one-lung ventilation, the arterial oxygen saturation suddenly drops to 85%. Initial troubleshooting steps, including assessment of DLT position, have been unsuccessful. What is the MOST appropriate next step in managing this acute hypoxemia?

In a patient undergoing one-lung ventilation for a left lower lobectomy, you observe a progressive increase in the peak inspiratory pressure of the ventilated lung. Auscultation reveals decreased breath sounds on the right side. What is the MOST likely cause of this change?

What is the underlying mechanism by which chronic hypoxemia leads to right ventricular dysfunction in COPD patients?

Which statement accurately relates FEV1 results to the potential benefits of bronchodilator therapy in COPD patients?

A patient presents with a constellation of symptoms including proximal muscle weakness that improves with repeated exertion. Diagnostic workup reveals the presence of an underlying lung malignancy. Which specific paraneoplastic syndrome is most likely contributing to this patient's presentation?

A patient with COPD is scheduled for lung resection. Preoperative evaluation reveals treatment with cisplastin. What specific perioperative concern should be anticipated?

A 68-year-old male with a 50 pack-year smoking history is diagnosed with squamous cell carcinoma of the lung. Given the typical pathophysiology of this cancer type, which of the following complications is most likely to arise directly from the tumor's location and growth pattern?

A patient is diagnosed with a peripheral lung lesion and undergoes a biopsy revealing adenocarcinoma. Further molecular testing identifies a mutation associated with increased growth factor signaling. Which of the following subsequent clinical courses is most anticipated, given the characteristics of adenocarcinoma? select 2

What is the underlying mechanism to why patients with carcinoid syndrome can have intraoperative hemodynamic instability?

What is the purpose of a mediastinoscopy?

What complications are commonly associated with mediastinoscopy? (Select all that apply)

Which type of non-small cell carcinoma is considered the most aggressive?

Match the lung cancer to its appropriate description:

What type of tumor is typically a large space-occupying lesion that can be benign or malignant and is associated with mesothelioma?

Which type of tumors are typically benign and noted to cause pneumonia distal to the tumor?

What are the signs and symptoms of Horner's syndrome? (Select all that apply)

Why is Horner syndrome associated with lung cancer?

What are the signs and symptoms of Pancoast syndrome? (Select all that apply)

What is the cause of Pancoast syndrome?

What are the two most common paraneoplastic syndromes associated with lung cancer?

What is Trousseau syndrome?

What chemotherapy medication is associated with cardiac toxicity?

What are the three pillars that serve as predictors of postoperative pulmonary complications for patients undergoing pulmonary surgery?

What is FEV1?

Which pulmonary function test (PFT) helps determine obstructive vs restrictive disease?

What is the most valid single test for post-thoracotomy respiratory complications?

Which PPO FEV1 is associated with increased risk of post-thoracotomy respiratory complications?

Which preoperative FEV1 is associated with a high risk of post-thoracotomy respiratory complications?

Predicted post-op DLCO < 40% → Increased complications Predicted Postoperative FEV1 (ppoFEV1) <40% → Increased complications

What test correlates with the total functional surface of the alveolar-capillary interface?

Which lung function test can be adversely affected by preoperative chemotherapy?

Inability to climb 1 flight of stairs is indicative of a VO2 max of less than ___ ml/kg/min and is associated with an ____ risk of postoperative complications.

What is VO2 max?

Which of the following are associated with an increased risk of postoperative complications? (Select all that apply)

Lung Lobes

Carina

Mainstem Intubation Risk

Average ETT Depth

Mediastinoscopy Complications

Non-Small Cell Lung Cancer (NSCLC)

Small Cell Lung Cancer (SCLC)

Large Cell Lung Cancer

Adenocarcinoma (Lung)

Squamous Cell Lung Cancer

Hamartomas (Lung)

Bronchial Adenomas

Carcinoid Tumors (Lung)

Postoperative O2 Management

RV Dysfunction in COPD Cause

Cor Pulmonale

4 M's of Preoperative Assessment

Pulmonary Toxic Medications

FEV1

FEV1 Reversibility Test

FVC

Carcinoid Syndrome Hormones

SVC Syndrome

Pancoast Syndrome

Paraneoplastic Syndromes

Hypercalcemia (Lung Cancer)

SIADH (Lung Cancer)

Lambert-Eaton Syndrome

Cushing Syndrome (Lung Cancer)

COPD

Migratory Thrombophlebitis (Trousseau Syndrome)

Mediastinoscopy

Anterior Mediastinal Tumor Concern

Smoking and Lung Cancer

Lung Cancer Mortality

Mediastinum contents

Overinflated Lungs (COPD)

Resectability

Operability

Respiratory Mechanical Function

Lung Parenchymal Function

Cardiopulmonary Interaction

RV/TLC Ratio

Lung Cancer Early S/S

Horner Syndrome Triad

SVC Syndrome Signs

Pancoast Syndrome Symptoms

Hypercalcemia Symptoms

SIADH Lab Finding

LEMS Muscle Strength

LEMS & Anesthesia

Cushing Syndrome Symptoms

COPD Types