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09/19/2022
Dr. Niels F. Jensen, M.D.: Oral Board PREP
Dr. Niels F. Jensen, M.D.: Oral Board PREP Dr. Jensen Anesthesiology Board PREP Post-graduate Review Education Programs The Best Medicine For Your Written, Oral, and Pain Boards Dear Dr., Niels…
Putting in the hours studying for the Written Boards?
Combine the #1 home study materials with the #1 course and you have a powerful combination for success on Written Boards. Big Blue, Baby Blue, Ranger Blue, and online testing are the premier tools to focus upon Written Board content. The "question and answer" course is the most efficient manner to review relevant information and assess strengths and weaknesses. The program is critically and fundamentally different from others in that it provides the integration and focus you need to win. Too often, valuable preparation time is spent in an unfocused manner. The mission of this program is to relentlessly focus upon the very information most likely to be tested.
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Question Monday from Dr. Jensen Online Question Bank!
Single best answer
A 64-year-old, 90-kg woman, who had hepatitis at age 22 and has a long history of asthma for which she takes prednisone, is undergoing cholecystectomy with fentanyl-nitrous oxide-oxygen anesthesia supplemented by rocuronium. Thirty minutes after induction the surgeon states that exposure is becoming more difficult and moderately intense wheezing is apparent. Blood pressure is increased from 110/60 to 150/90 torr, and heart rate is 130/min. Your first response should be to:
A. obtain arterial blood gas analysis
B. administer pancuronium, 10 mg
C. administer isoflurane
D. administer propranolol
E. administer epinephrine, 50 µg intravenously1.
Answer: See Below!
A. obtain arterial blood gas analysis
B. administer pancuronium, 10 mg
C. administer isoflurane
D. administer propranolol
E. administer epinephrine, 50 µg intravenously1.
Answer: C. administer isoflurane
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Studying for Oral Boards?
The Oral Board program combines the best homestudy materials with the top course for Oral Boards. Big Red and Spiels are the premier homestudy tools for verbal organization. Ranger Red Cases and Audio MP3's put scripting, practice, and outlining together to turn it into a "talking test"--exactly what it is. The course is the toughest and the best. No one has coached Oral Board Prep as much or as well as Dr. Jensen.
Failing the Oral exam is usually due to incomplete knowledge, poor organization, or inadequate presentation of essential material. Listening to lectures in a review course provides some useful review of information but does not help you organize and verbalize essential information. Success can be found in a combination of well-honed knowledge, excellent organization and effective practice--exactly what the program delivers.
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Question Monday from Dr. Jensen Online Question Bank!
Which of the following serum laboratory tests is indicated for confirmation of the diagnosis of anaphylaxis?
A. C1 esterase
B. Tryptase
C. Complement
D. Histamine
E. Anti-cardiolipin
Answer: See Below
Diagnosis of anaphylaxis
1. “Anaphylaxis is a severe immune-mediated reaction that affects the cardiovascular, pulmonary, cutaneous, and gastrointestinal systems. Anaphylaxis and anaphylactoid reactions are identical in clinical presentation and treatment. A suspicion of anaphylaxis requires evaluation to determine the cause and confirm the diagnosis.”
2. “Tryptase is a serine protease released mainly from secretory granules in mast cells. When attempting to confirm anaphylaxis, it is best to draw a tryptase level within one to three hours and within five to six hours from the onset of symptoms. A normal tryptase level is typically below 11 mg/mL. Although elevated tryptase levels likely confirm anaphylaxis, normal levels do not rule out anaphylaxis, especially if blood sample acquisition was delayed. To specifically diagnose anaphylaxis, an elevated tryptase level followed by a normal repeat tryptase level 24 hours later is needed. If both early and delayed tryptase levels are elevated, a diagnosis of mastocytosis (mast cell disorder) should be considered.”
3. “A low C1 esterase is useful to diagnose hereditary angioedema which typically causes angioedema of the upper airway tract. Complement levels are typically low after anaphylaxis. Histamine levels peak within 10 minutes and resolve within 60 minutes in anaphylaxis cases. Neither C1 esterase, complement, nor histamine levels is specific enough to rule in anaphylaxis.”
4. “Tryptase levels can be used to confirm a diagnosis of anaphylaxis.” Therefore, the best answer is C.
Answer: C. Complement
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Are you struggling to study? Our Written and Oral Board home-study books bring under one roof everything you need to pass. Focused study is the key!
It would be an honor to work with you. I send along my best wishes and regards.
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Question Monday from Dr. Jensen Online Question Bank!
A 35 year old female sustained burns to her face. She has metabolic acidosis. What is the most likely reason?
A. Hypovolemia
B. Decreased cardiac output
C. Carbon monoxide poisoning
D. ARDS
E. none, metabolic acidosis inconsistent with clinical scenario
Answer: See Below!
35 year old female with burns to her face, now with metabolic acidosis. Cause?
1. Points which stick out here are the metabolic acidosis which is now apparently present and the fact that the burn is noted to specifically involve the face--raising the prospect of inhalational involvement and injury. Be careful. . . Board examiners shoot down knee-jerkers first, so don’t jump to round up the usual suspects of hypovolemia and carbon monoxide poisoning.
2. The fact that this involves the face limits the degree of hypovolemia, even though it would still be significant. Would it be significant enough to cause academia? Tough call, it’s not unreasonable and in fact could be argued for. The question is weather another “single best” exists.
3. Let’s review smoke inhalation and with special attention to the issue of metabolic acidosis, a linkage which is certainly not upper most in our minds. This analysis shows, in fact, it should be and that metabolic acidosis goes hand in hand with asphyxiation. . .
Haddad and Winchester's Clinical Mgt of Poisoning and Drug Overdose
At a Glance…
▪ Smoke inhalation accounts for more than 80% of fire-related fatalities, most of which result from residential fires.
▪ The pathophysiology of smoke inhalation is multifactorial and involves additive or synergistic toxicity from hypoxia, thermal injury, and numerous chemical toxins (e.g., carbon monoxide, hydrogen cyanide, irritant gases).
▪ The ultimate cause of death in patients with smoke inhalation is asphyxia (i.e., tissue hypoxia and consequentacidosis).
▪ Thecarboxyhemoglobinfraction is elevated in virtually all patients exhibiting signs and symptoms of asphyxia.
▪ Unexplained coma, severe metabolic (lactic)acidosis, and refractory hypotension victims suggests cyanide poisoning.
▪ Urgent endotracheal intubation is indicated in patients with cyanosis or hypoxemia despite oxygen therapy, respiratory depression or acute hypercarbia, pulmonary edema, altered mental states, full-thickness burns of the face or neck, and respiratory distress due to upper airway obstruction.
▪ Intubation should also be considered for patients with upper airway pathology on laryngoscopy or a respiratory rate of more than 30 breaths/min who do not improve with oxygen or other pharmacologic therapy.
▪ Hyperbaric oxygen can be effective in treating carbon monoxide or cyanide poisoning, cerebral edema, and thermal burns; it should also be considered for patients with refractory hypoxemia.
▪ When cyanide poisoning is suspected in smoke inhalation victims, sodium thiosulfate may be administered without nitrates.
Answer: C. Carbon monoxide poisoning
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Struggling to study or pass?
We train the best to be their best, and our track record is strong: we’ve helped over 30,000 anesthesiologists become Board certified over the past 30 years with premier home-study materials, live and virtual courses, sound, and question banks. We specialize in helping anesthesiologists who struggle with standardized tests, usually for a variety of reasons. If you have failed, or are at risk of failing, call us ASAP. We can help!
We’d love to work with you, so please consider our transformative books and sound, our online testing center which has the highest quality questions and answers, our Zoom meetings, and our live course dates at www.boardprep.com.
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Question Monday from Dr. Jensen Online Question Bank!
Which of the following is typically associated with photosensitivity:
A. Garlic
B. Ginseng
C. Gingko
D. St. Johns wort
E. none of the above
Answer: See Below!
Nutraceuticals: photosensitivity
1. Remember, when it comes to neutraceuticals, “The G’s cause C’s,” namely coagulopathies.
2. Let’s look at the players:
Garlic
a. Garlic has been used for centuries for a variety of ailments. Recent studies have centered upon purported vasodilator and hypocholesterolemic activity. A British study suggests garlic may lower total cholesterol by 12%, while other studies are nonconfirmatory. Less solid evidence exists for antihypertensive effects. An important side effect appears to be decreased platelet aggregation. Garlic may augment the effects of warfarin, heparin, nonsteroidal anti-inflammatory agents, and aspirin. One reported case links garlic to spontaneous spinal/epidural hematoma.
Ginseng
a. The active compound in ginseng is ginsenoside. It has been used for anti-aging, energy boosting, and as an aphrodisiac. Ginseng has also been shown to have a hypoglycemic effect and should be avoided in in patients on insulin or oral hypoglycemics. Like garlic, ginger, and ginko ginseng should be avoided in patients on coumadin, heparin, NSAIDs, and aspirin or those requiring neuraxial blockade. Ginseng also causes hypertension. Ginseng should not be used with MAOIs as manic episodes have resulted from this combination.
Ginko biloba
a. Ginko has been used for medicinal purposes since 3000 B.C. It is one of the best-selling herbs in the United States, with annual revenue exceeding $250 million. It is used for a variety of purposes including intermittent claudication, tinnitus, memory loss, and impotence. Ginko is considered relatively safe but has been associated with bleeding abnormalities, including spontaneous hyphema (bleeding from the iris into the anterior chamber), subarachnoid hemmorhage, and spontaneous subdural hematoma. Like garlic and ginger, ginko should be avoided in patients on coumadin, heparin, NSAIDs, and aspirin or those requiring neuraxial blockade. Ginko should also probably be avoided with the concomitant use of anticonvulsives and TCAs, as it seems to decrease the effectiveness of these agents by an unknown mechanism.
St. John’s Wort
a. St. John’s Wort is most commonly used for anxiety, depression, and sleep disorders. It is one of the most popular drugs in Germany, with several million regular users. Its mechanism of action is likely to be GABA or serotonin receptor inhibition. Photosensitivity is the most common side effect and photosensitive drugs such as tetracycline and piroxicam should not but used concomitantly.
Answer: D. (St. Johns wort)
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07/07/2022
Niels F. Jensen, M.D., is the #1 Board Coach in the United States. He has coached more anesthesiologists through boards than anyone. One-third of all board-certified anesthesiologists have worked with Dr. Jensen to achieve certification. No one has focused on the requirements of anesthesiology Board certifications and no one is in a better position to help you beat the beast of Boards.
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Preparing for the Written Board Exam?
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08/30/2021
Question Monday from Dr. Jensen Online Question Bank!
single best answer
Modified Old Board Question
A 60-year-old, 70-kg man with moderately severe osteoarthritis continues to bleed following a femoral-popliteal bypass operation. He has received 1000ml of ACD-stored blood and 1000 ml of lactated Ringer solution plus 3500 units of heparin. Coagulation tests showed a normal prothrombin time and prolonged plasma thromboplastin time. Bleeding time is normal and the platelet count is 105,000/mm3. The best treatment is administration of
A. fresh frozen plasma
B. fresh whole blood
C. protamine sulfate
D. vitamin K
E. platelets
Answer: See Below!
Continued bleeding following fem-pop
1. From the blood section of the blue book is a good list, a differential of post-op bleeding:
a. Factor deficiency
b. Platelets low
c. DIC
d. Surgical bleeding
e. Residual heparin
2. Heparin can cause prolongation of both PT and PTT. At lower doses it can strike selectively at the PTT, as is the case here.
Answer: C
AKT Topic: Anesthesia and Anesthetic techniques (25%) and/or AKT Topic: Resuscitation and/or AKT Topic Physiology
BASIC ABA CONTENT OUTLINE KEYWORD: Clinical Sciences: Anesthesia Procedures, Methods, and Techniques: Evaluation of the Patient and Preoperative Preparation: Premedication: Continuation vs. Discontinuation of Chronic Medications: Antihypertensives, Anti-Anginal, Antihyperglycemics, Antidepressants, Platelet Inhibitors, etc.
BASIC ABA CONTENT OUTLINE KEYWORD: Organ-Based Basic and Clinical Sciences: Hematologic System: Pharmacology: Anticoagulants, Anti-thrombotics, and Anti-Platelet Drugs: Mechanism of Action
BASIC ABA CONTENT OUTLINE KEYWORD: Organ-Based Basic and Clinical Sciences: Hematologic System: Pharmacology: Anticoagulants, Anti-thrombotics, and Anti-Platelet Drugs: Comparison of Drugs
ADVANCED ABA CONTENT DOMAIN KEYWORD TOPICS: Organ-Based Advanced Clinical Sciences: Cardiovascular System: Clinical Sciences: Cardiopulmonary Bypass: Anticoagulation and Antagonism; Activated Clotting Time (ACT) and Other Clotting Times, Heparin Assays, Antithrombin III, Protamine Reactions, Heparin and Protamine Alternatives
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08/23/2021
Question Monday from Dr. Jensen Online Question Bank!
single best answer
Modified Old Board Question
A 57-year-old woman with 2-vessel coronary artery disease (LAD, circumflex), who is scheduled for coronary bypass grafting, receives midazolam orally for premedication. On arrival in the operating room, she is mildly sedated and has epigastric and substernal pain. Heart rate is 112/min and blood pressure is 145/95 torr. Therapy should include intravenous administration of which of the following:
A. 0.25 mg flumazenil
B. 0.2 mg naloxone
C. 0.5 mg propranolol
D. 0.1 mg phenylephrine
E. none of the above
Answer: See Below!
Chest pain in setting in CABG: treatment
1. Myocardial oxygen consumption is controlled by preload, afterload, and contractility. In this situation, we must control heart rate and the administration of propranolol would be appropriate. Flumazenil at this juncture and with these symptoms, would not be indicated, and nor would any of the other agents. But a case can be made for propranolol to decrease HR and BP, two factors increasing myocardial oxygen consumption--choice C.
Answer: C
AKT Topic: Physiology
BASIC ABA CONTENT OUTLINE KEYWORD: Clinical Sciences: Anesthesia Procedures, Methods, and Techniques: Evaluation of the Patient and Preoperative Preparation: Premedication: Prophylactic Cardiac Risk Reduction: Beta-Adrenergic Blockers, Etc.
BASIC ABA CONTENT OUTLINE KEYWORD: Organ-Based Basic and Clinical Sciences: Cardiovascular System: Physiology: Ventricular Function: Myocardial Oxygen Utilization
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08/16/2021
Question Monday from Dr. Jensen Online Question Bank!
Keyword remembered
Single best
You perform a nerve block. The nerve stimulator is 1 cm from the nerve and you get a twitch at 2 ma. What will be the current required for twitch at 0.5 cm?
a. 0.5 ma
b. 0.75 ma
c. 1ma
d. 2.5 ma
e. 3 ma
Answer: See Below
Nerve stimulator fun
1. Consultant engineer-anesthesiology Professor, Frank Scamman: “To answer your question, I must assume that the current pattern from the end of the stimulating needle is spherical. The area of a sphere varies directly with the square of the radius. I further assume that the nerve is sensitive only to the local current density of the stimulus. If the distance from the needle to the nerve is halved, then the area of the sphere is reduced by 4, making the current density 4 times greater. Therefore, the current at 0.5 cm will be 4 times less or 0.5 ma.”
Answer: A
AKT Topic: Physics, Instrumentation,Monitoring
BASIC ABA CONTENT OUTLINE KEYWORD: Basics Pharmacology: General Concepts: Anesthetics-Intravenous (Opioid and Non-Opioid Induction and Anesthetic Agents): Muscle Relaxants (Depolarizing, Non-Depolarizing): Antagonism of Blockade
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08/09/2021
Question Monday from Dr. Jensen Online Question Bank!
Single best
Keyword
A morbidly obese patient is induced with general anesthesia and during the first two attempts to intubate, direct laryngoscopy (DL) is unsuccessful. Attempts to ventilate are marginally successful. What is next best step:
A. retrograde wire placement
B. Combitube
C. tracheostomy
D. cricothyroidotomy
E. LMA
Answer: See Below!
Treatment: failed intubation in setting of obesity
The ASA failed airway protocol clearly lists the LMA as the backup of choice in the setting of a failed intubation in the cannot intubate/cannot ventilate scenario.
Answer: E
BASIC ABA CONTENT OUTLINE KEYWORD: Clinical Sciences: Anesthesia Procedures, Methods, and Techniques: Evaluation of the Patient and Preoperative Preparation: Premedication NPO and Full Stomach Status; Implications for Airway Management, Choice of Anesthesia Technique and Induction of Anesthesia; Gastric Emptying Time; Preoperative; Full Stomach and Induction of Anesthesia
BASIC ABA CONTENT OUTLINE KEYWORD: Clinical Sciences: Anesthesia Procedures, Methods, and Techniques: Airway Management: Techniques for Managing Airway: Awake vs. Asleep, Use vs. Avoidance of Muscle Relaxants, Drug Selection, Retrograde Intubation Techniques, ASA Difficult Airway Algorithm
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08/04/2021
Dr. Niels F. Jensen, M.D.: Written Board PREP
Dr. Niels F. Jensen, M.D.: Written Board PREP Dr. Jensen Anesthesiology Board PREP Post-graduate Review Education Programs The Best Medicine For Your Written, Oral, and Pain Boards Dear Dr. , Niels F. Jensen, M.D., is the #1 Board Coach in the […]
08/02/2021
Question Monday from Dr. Jensen Online Question Bank!
Single best answer
Modified Old Board Question
A healthy, 21-year-old patient who is emerging from nitrous oxide-oxygen-isoflurane anesthesia for cholecystectomy is being ventilated by a pressure-limited ventilator. As he becomes more awake, the tidal volume gradually decreases. The change in tidal volume is secondary to
A. increased airway resistance
B. decreased pulmonary compliance
C. decreased frequency-dependent compliance
D. decreased total compliance
E. decreased surfactant activity
Clinical scenario: a patient who is emerging from nitrous oxide-oxygen-isoflurane anesthesia for cholecystectomy is being ventilated by a pressure-limited ventilator. As he becomes more awake, the tidal volume gradually decreases. The change in tidal volume is secondary to:
Answer: See Below!
Clinical scenario: patient who is emerging from nitrous oxide-oxygen-isoflurane anesthesia for cholecystectomy is being ventilated by a pressure-limited ventilator. As he becomes more awake, the tidal volume gradually decreases. The change in tidal volume is secondary to:
Chest wall compliance decreases, and airway resistance increases upon awakening from anesthesia. This results in an increase in peak pressures and eventually to failure of a pressure limited ventilator to deliver a full tidal volume.
Answer: D
AKT Topic: Physiology
BASIC ABA CONTENT OUTLINE KEYWORD: Basics. Physics, Monitoring, and Anesthesia Delivery Devices: Physics of Anesthesia Machine/ Breathing System: Principles: Resistance, Turbulent Flow, Mechanical Dead space, Rebreathing, Dilution, Leaks, Gas Mixtures, Humidity, Heat
BASIC ABA CONTENT OUTLINE KEYWORD: Basics. Physics, Monitoring, and Anesthesia Delivery Devices: Physics of Anesthesia Machine/ Breathing System Characteristics
BASIC ABA CONTENT OUTLINE KEYWORD: Basics. Physics, Monitoring, and Anesthesia Delivery Devices: Ventilators: Monitors; Pressure (Plateau, Peak), Oxygen, Apnea, Inspiratory/Expiratory Ratio, Dynamic Compliance, Static Compliance
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Let's talk Written Boards! The Written Board program is critically and fundamentally different from others in that it provides the integration and focus you need to win. Too often, valuable preparation time is spent wandering, wandering through only marginally helpful materials. The objective and mission of this course is to maximize integration and focus, minimize wandering, and help you accomplish the twin goal of passing the examination and becoming a better anesthesiologist.
The Written Exam is a difficult test. The Written Board program outlined amounts to a broad and comprehensive attack against these examinations, designed to deliver a knockout blow. It involves essential information in the form of books for home study, lectures, audio MP3, keywords, and courses.
Big Blue
Commuting to work is often a waste of time for boards. Your mind is fresh but circumstances don't permit study. Audio Blue and Ranger Blue are the only audio sources available with demonstrated keyword correlation. Ranger Blue is clearly and demonstrably based and keywords and covers some of the most difficult and frequently tested topics for written boards detailed notes are included. It may be just the tool missing from your game!of what you need to significantly boost your score and pass Written Boards
Baby Blue: Written PREP Cards
An OR companion to Big Blue. Most anesthesiologists have the will to win and the world to prepare to win but they severely lack the time to win. Effective studying during the best part of the day is crucial. Baby Blue covers a huge territory in terms of essential facts and concepts that are recurrent on this examination. It is easy to carry and use, in the form of cards in a small binder. This little companion may prove vital to your overall strategy for victory.
Audio Blue: MP3
Commuting to work is often a waste of time for boards. Your mind is fresh but circumstances don't permit study. Audio Blue and Ranger Blue are the only audio sources available with demonstrated keyword correlation. Ranger Blue is clearly and demonstrably based and keywords and covers some of the most difficult and frequently tested topics for written boards detailed notes are included. It may be just the tool missing from your game! for multiple reads. By listening for just one hour a day, Big Blue can be "read" in three weeks. One can truly command the information in the Big bBlue this way. This is the power of Audio Blue and precisely why it has been so successful. Audio Blue works!
Ranger Blue: MP3
Commuting to work is often waste of time for boards. Your mind is fresh but circumstances don't permit study. Audio Blue and Ranger Blue are the only audio sources available with demonstrated keyword correlation. Ranger Blue is clearly and demonstrably based and keywords and covers some of the most difficult and frequently tested topics for written boards detailed notes are included. It may be just the tool missing from your game!
Courses: Online
Even the best plan rarely survives contact. Your study plan and efforts need to be tested. This is very valuable to refine and focus further effort. The course hammers away at topics, questions, and keywords. It is question and answer based. It simulates the exam in terms of likely question topics, accustoms you to the pacing of the examination, and tests your knowledge of likely topic areas so you can focus especially hard on these in subsequent preparation.
The Online Test Center is now open! Benefit from course A, eight tests, nearly 1,000 questions. Each test is available for $99 each or a package rate for $499.
Niels F. Jensen, M.D., is the #1 Board Coach in the United States. He has coached more anesthesiologists through boards than anyone. One-third of all board-certified anesthesiologists have worked with Dr. Jensen to achieve certification. No one has focused upon the requirements of anesthesiology Board certifications and no one is in a better position to help you beat the beast of Boards.
Onward to Victory!
07/26/2021
Question Monday from Dr. Jensen Online Question Bank!
Keyword Remembered
Single best
Which best describes characteristic EKG manifestation of calcium toxicity?
a. peaked T wave
b. biphasic P wave
c. narrow QRS complex
d. short PR interval
e. wide QRS complex
Answer: See Below!
EKG manifestations of hypercalcemia
1. Pillbox: Hypercalcemia manifestations: Hypercalcemia causes weakness, cardiac conduction abnormalities, renal failure and renal stones. When serum concentration exceeds 8 meq/l, conduction system abnormalities, namely prolonged PR interval and widened QRS occur. When serum concentration exceeds 10 m eq/l, aggressive therapy is necessary.
2. Don’t forgot, like I too often do, hypocalcemia is associated with prolonged QT intervals.
Answer: E
AKT Topic: Physiology
BASIC ABA CONTENT OUTLINE KEYWORD: Organ-Based Basic and Clinical Sciences: Central and Peripheral Nervous Systems: Physiology: Skeletal Muscle Contractions; Depolarization, Role of Calcium, Actin/Myosin; Energy Source and Release
BASIC ABA CONTENT OUTLINE KEYWORD: Organ-Based Basic and Clinical Sciences: Cardiovascular System: Anatomy: Coronary Circulation: Pharmacology: Electrolytes (Potassium, Magnesium, Phosphorus, Calcium): Cardiovascular Effects
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Online Test Center now open!
Benefit from course A, eight tests, over 1,000 questions. Each test is available for $99 each or a package rate for $499.
Buy today!
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Onward To Victory!
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Question Monday from Dr. Jensen Online Question Bank!
Single best answer
Modified Old Board Question
The most sensitive test for the evaluation of obstructive airway disease is the measurement of
A. peak flow rate
B. maximum expiratory flow rate (MEF 200-1200)
C. forced expiratory volume in 1 second (FEV1)
D. mid-maximum flow rate (MMF 25-75%)
E. forced vital capacity
Answer: See Below!
1. Mid-maximal expiratory flow rate: the best indicator for small airway (obstructive) disease 1. Pulmonary function tests emphasizing the early portion of the expiratory flow curve, such as peak flow and maximum expiratory flow rate (MEF 200-1200), are poor tests for evaluation of airway obstruction. This is because they are highly effort dependent. This applies to any test that focuses on the portion of the expiratory flow curve above 75% of total lung capacity.
2. Measurement of forced expiratory volume in 1 second (FEV1) is less effort dependent and can document significant increases in airway resistance. It is, however, primarily a reflection of increased resistance in large airways (greater than 2 mm internal diameter), which makes up 80 to 90% of total resistance.
3. Measurement of mid-maximum flow rate (MMF25-75%) is the least effort-dependent test because, below 75% of total lung capacity, flow is limited by airway resistance, and is minimally affected by effort. This test is thought to be the most sensitive reflection of the true mechanical state of the airways, including the small airways (less than 2 mm internal diameter) where the earliest changes in obstructive airway disease are found.
4. Because forced vital capacity is a measure of volume rather than flow rate, it is not particularly useful in evaluation of mild to moderate obstructive airway disease.
Answer: D
AKT Topic: Preanesthetic assessment
BASIC ABA CONTENT OUTLINE KEYWORD: Basics. Physics, Monitoring, and Anesthesia Delivery Devices: Monitoring Methods: Ventilation: Respirometers, Inspiratory Force, Spirometry, Flow-Volume Loops (see also ENT, Machines
ADVANCED ABA CONTENT DOMAIN KEYWORD TOPICS: Organ-Based Advanced Clinical Sciences: Respiratory system: Restrictive Disease: Neurologic: CNS Depression, Spinal Cord Dysfunction, Peripheral Nervous System
ADVANCED ABA CONTENT DOMAIN KEYWORD TOPICS: Organ-Based Advanced Clinical Sciences: Respiratory system: Restrictive Disease Musculoskeletal: Muscular, Skeletal, Obesity, Chest Trauma
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