Page 1 of 90
STOELTING'S ANESTHESIA AND CO-EXISTING DISEASE (9TH EDITION) – NEWEST
EDITION 2026 EXAM LATEST VERSION SOLVED QUESTIONS & ANSWERS VERIFIED 100
%
Stoelting's Anesthesia and Co-Existing Disease (9th Edition) –Questions with
Detailed Rationales
SECTION 1: RESPIRATORY & SLEEP-RELATED DISORDERS (Q1–Q25)
Q1. During natural sleep, repetitive episodes occur in which inspiratory effort
continues but airflow stops because the pharyngeal airway collapses. Which
mechanism best identifies the disorder?
A. Loss of central respiratory drive without inspiratory effort
B. Fixed intrathoracic tracheal stenosis
C. Recurrent upper-airway obstruction despite ongoing respiratory effort
D. Primary impairment of pulmonary diffusion
Correct Answer: C
Rationale: Obstructive sleep apnea is characterized by repetitive upper-airway
narrowing or collapse during sleep while respiratory effort persists. Reduced pharyngeal
dilator muscle tone during sleep allows a susceptible airway to collapse.
Q2. An anesthesia plan is being developed for a patient with untreated severe OSA
who will require postoperative analgesia. Which complication deserves particular
attention?
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A. Opioid- and sedative-associated worsening of upper-airway obstruction and
ventilatory depression
B. Fixed tracheal stenosis requiring rigid bronchoscopy
C. Predominant diffusion limitation responsive to high FiO₂
D. Loss of central respiratory drive without obstruction
Correct Answer: A
Rationale: Opioids and sedatives can reproduce or intensify several mechanisms that
normally promote obstruction during sleep, worsening upper-airway obstruction and
ventilatory depression in patients with untreated severe OSA.
Q3. Which of the following is a characteristic feature of obstructive sleep apnea?
A. Absent respiratory effort during apneic episodes
B. Continued respiratory effort during apneic episodes
C. Fixed upper airway obstruction
D. Primary diffusion impairment
Correct Answer: B
Rationale: OSA is characterized by continued respiratory effort against a collapsed
upper airway, distinguishing it from central sleep apnea where respiratory effort is
absent.
Q4. Which of the following is a risk factor for obstructive sleep apnea?
A. Obesity
B. Male sex
C. Advanced age
D. All of the above
Correct Answer: D
Rationale: Risk factors for OSA include obesity, male sex, advanced age, craniofacial
abnormalities, and family history.
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Q5. What is the primary mechanism of upper airway collapse in obstructive sleep
apnea?
A. Loss of pharyngeal dilator muscle tone during sleep
B. Fixed tracheal stenosis
C. Central respiratory depression
D. Pulmonary diffusion impairment
Correct Answer: A
Rationale: Reduced pharyngeal dilator muscle tone during sleep allows a susceptible
airway to collapse, causing obstructive apnea.
Q6. Which of the following is a perioperative concern for patients with obstructive
sleep apnea?
A. Difficult mask ventilation
B. Difficult intubation
C. Postoperative respiratory depression
D. All of the above
Correct Answer: D
Rationale: Patients with OSA may present with difficult mask ventilation, difficult
intubation, and are at increased risk of postoperative respiratory depression.
Q7. What is the preferred technique for airway management in a patient with
known difficult intubation and OSA?
A. Awake fiberoptic intubation
B. Direct laryngoscopy
C. Blind nasal intubation
D. Laryngeal mask airway
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Correct Answer: A
Rationale: Awake fiberoptic intubation is the preferred technique for patients with
known difficult intubation, allowing visualization of the airway while maintaining
spontaneous ventilation.
Q8. Which of the following is a characteristic of obstructive lung disease?
A. Increased airway resistance
B. Decreased compliance
C. Normal airway resistance
D. Increased lung volumes only
Correct Answer: A
Rationale: Obstructive lung disease is characterized by increased airway resistance, air
trapping, and prolonged expiration.
Q9. What is the primary pathophysiologic mechanism of emphysema?
A. Destruction of alveolar walls
B. Increased mucus production
C. Bronchoconstriction
D. Airway inflammation
Correct Answer: A
Rationale: Emphysema is characterized by destruction of alveolar walls, leading to loss
of elastic recoil and air trapping.
Q10. Which of the following is a perioperative concern for patients with COPD?
A. Increased risk of postoperative pulmonary complications
B. Difficult intubation
C. Hyperkalemia
D. Hyperglycemia
STOELTING'S ANESTHESIA AND CO-EXISTING DISEASE (9TH EDITION) – NEWEST
EDITION 2026 EXAM LATEST VERSION SOLVED QUESTIONS & ANSWERS VERIFIED 100
%
Stoelting's Anesthesia and Co-Existing Disease (9th Edition) –Questions with
Detailed Rationales
SECTION 1: RESPIRATORY & SLEEP-RELATED DISORDERS (Q1–Q25)
Q1. During natural sleep, repetitive episodes occur in which inspiratory effort
continues but airflow stops because the pharyngeal airway collapses. Which
mechanism best identifies the disorder?
A. Loss of central respiratory drive without inspiratory effort
B. Fixed intrathoracic tracheal stenosis
C. Recurrent upper-airway obstruction despite ongoing respiratory effort
D. Primary impairment of pulmonary diffusion
Correct Answer: C
Rationale: Obstructive sleep apnea is characterized by repetitive upper-airway
narrowing or collapse during sleep while respiratory effort persists. Reduced pharyngeal
dilator muscle tone during sleep allows a susceptible airway to collapse.
Q2. An anesthesia plan is being developed for a patient with untreated severe OSA
who will require postoperative analgesia. Which complication deserves particular
attention?
, Page 2 of 90
A. Opioid- and sedative-associated worsening of upper-airway obstruction and
ventilatory depression
B. Fixed tracheal stenosis requiring rigid bronchoscopy
C. Predominant diffusion limitation responsive to high FiO₂
D. Loss of central respiratory drive without obstruction
Correct Answer: A
Rationale: Opioids and sedatives can reproduce or intensify several mechanisms that
normally promote obstruction during sleep, worsening upper-airway obstruction and
ventilatory depression in patients with untreated severe OSA.
Q3. Which of the following is a characteristic feature of obstructive sleep apnea?
A. Absent respiratory effort during apneic episodes
B. Continued respiratory effort during apneic episodes
C. Fixed upper airway obstruction
D. Primary diffusion impairment
Correct Answer: B
Rationale: OSA is characterized by continued respiratory effort against a collapsed
upper airway, distinguishing it from central sleep apnea where respiratory effort is
absent.
Q4. Which of the following is a risk factor for obstructive sleep apnea?
A. Obesity
B. Male sex
C. Advanced age
D. All of the above
Correct Answer: D
Rationale: Risk factors for OSA include obesity, male sex, advanced age, craniofacial
abnormalities, and family history.
, Page 3 of 90
Q5. What is the primary mechanism of upper airway collapse in obstructive sleep
apnea?
A. Loss of pharyngeal dilator muscle tone during sleep
B. Fixed tracheal stenosis
C. Central respiratory depression
D. Pulmonary diffusion impairment
Correct Answer: A
Rationale: Reduced pharyngeal dilator muscle tone during sleep allows a susceptible
airway to collapse, causing obstructive apnea.
Q6. Which of the following is a perioperative concern for patients with obstructive
sleep apnea?
A. Difficult mask ventilation
B. Difficult intubation
C. Postoperative respiratory depression
D. All of the above
Correct Answer: D
Rationale: Patients with OSA may present with difficult mask ventilation, difficult
intubation, and are at increased risk of postoperative respiratory depression.
Q7. What is the preferred technique for airway management in a patient with
known difficult intubation and OSA?
A. Awake fiberoptic intubation
B. Direct laryngoscopy
C. Blind nasal intubation
D. Laryngeal mask airway
, Page 4 of 90
Correct Answer: A
Rationale: Awake fiberoptic intubation is the preferred technique for patients with
known difficult intubation, allowing visualization of the airway while maintaining
spontaneous ventilation.
Q8. Which of the following is a characteristic of obstructive lung disease?
A. Increased airway resistance
B. Decreased compliance
C. Normal airway resistance
D. Increased lung volumes only
Correct Answer: A
Rationale: Obstructive lung disease is characterized by increased airway resistance, air
trapping, and prolonged expiration.
Q9. What is the primary pathophysiologic mechanism of emphysema?
A. Destruction of alveolar walls
B. Increased mucus production
C. Bronchoconstriction
D. Airway inflammation
Correct Answer: A
Rationale: Emphysema is characterized by destruction of alveolar walls, leading to loss
of elastic recoil and air trapping.
Q10. Which of the following is a perioperative concern for patients with COPD?
A. Increased risk of postoperative pulmonary complications
B. Difficult intubation
C. Hyperkalemia
D. Hyperglycemia
