Apex Midterm Exam (Latest 2026/2027 Update) Questions with Verified Answers| 100% Correct| Graded A.

Apex Midterm Exam (Latest 2026/2027
Update) Questions with Verified
Answers| 100% Correct| Graded A.
Question:

At what point during laparoscopic cholecystectomy is a gas embolism
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most likely to occur?
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A. Initial abdominal insufflation.
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B. During the cholangiogram
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C. The risk is the same throughout the procedure.
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D. Dissection of gallbladder from the liver bed.?
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Answer:

A. Initial abdominal insufflation.
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There is a risk of air embolism if a trocar is inadvertently placed into a
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blood vessel, or any time when intravascular pressure falls below
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intraabdominal pressure. i,- i,-




Gas embolism creates an airlock in the right heart, and thus obstructs
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forward flow. i,- i,-




Signs and symptoms include : decreased EtCO2, increased EtN, increased
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PAP, pulmonary edema, decreased blood pressure, hypoxia, dysrhythmias,
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cyanosis, and a mill wheel murmur. i,- i,- i,- i,- i,- i,-




TEE is the most sensitive indicator of gas embolism.
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,The risk of gas embolism is greatest during initial insufflation of the
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abdomen, especially those with previous abdominal surgery .
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Question:
Which finding places a child at the GREATEST risk for laryngospasm?
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A. Upper respiratory infection.
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B. Upper airway surgery.
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C. Exposure to secondhand tobacco smoke.
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D. Gastro esophageal reflux.?
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Answer:
A. Upper respiratory infection.
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Noxious stimulation of the internal branch of the superior, laryngeal,
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nerve and precipitate laryngospasm. This complication can lead to
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complete airway obstruction negative pressure pulmonary edema,
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aspiration of gastric contents, cardiac arrest, and death.
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The risk of laryngospasm is greatest in the child with an upper respiratory
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infection 9.6/100 i,-




The Distractors were the other risk factors for laryngospasm:
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-Preoperative risk factors include exposure to secondhand smoke and
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GERD. i,-




-Intra-operative risk factors include upper airway surgery, mechanical i,- i,- i,- i,- i,- i,- i,- i,-


irritant (secretions), airway manipulation during light planes of anesthesia,
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and the excitement phase during an inhalation induction.
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,Question:

Which lung volume increases as a function of aging??
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Answer:

Aging is associated with the loss of lung elastic recoil. Said another way,
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There is an increased lung compliance. Lung elastic recoil is integral to the
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maintenance of airway diameter. Loss of this property causes a small
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airways to collapse prematurely. This causes gas trapping, and gas
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trapping increases RESIDUAL VOLUME. i,- i,- i,-




Question:
A Morbidly obese patient is undergoing removal of an infected hip
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hardware under general anesthesia. Midway through the procedure you
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observe the following vital signs. What is the MOST likely diagnosis?
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Increased HR i,-




hypotension i,-




Increased CVP i,-




Drop in ETCO2 i,- i,-




Drop in O2 satsi,- i,- i,-




PIP increased
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A. PE
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B. Exsanguination.
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C. Myocardial infarction
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, D. Congestive heart failure.?
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Answer:

A. PE
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pulmonary embolism creates a mechanical obstruction in the pulmonary
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circulation. If the embolism is of sufficient size, it significantly increases
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dead space ventilation and pulmonary vascular resistance. A Precipitous
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fall in EtCO2 and tachycardia are usually the first signs of PE. Dead space
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ventilation, contributes to arterial hypoxemia. Cardiac filling pressures may
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increase as a result of increased PVR. Hypotension may occur &
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bronchospasm may increase peak inspiratory pressure. i,- i,- i,- i,- i,- i,-




Immediate treatment consists of 100% FiO2 and hemodynamic support
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with fluids and inotropes. If symptoms do not resolve, pulmonary
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embolectomy or thrombolysis in the non-surgical patient should be i,- i,- i,- i,- i,- i,- i,- i,- i,-



considered. i,-




MI, CHF and exsanguination can cause some, but not all, of the
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physiological changes in the question so these weren't the best options.
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Question:
Match each West zone of the lung with its corresponding pressures:
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Zone 1 i,-




Zone 2 i,- i,-




Zone 3 i,-




Zone 4? i,-




Answer:

Zone 1: P alveolar> P arterial> P venous> P interstitial (dead space)
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