1. Surgical patient

Question 1

What is Mallampati Classfication ?

Answer 1

• Predicts difficulty of intubation.
• Test is performed with the patient in the sitting position, the head held in a neutral position, the mouth wide open, and the tongue protruding to the maximum.

Question 2

Classes of Mallampati Classfication ?

Answer 2

􏱱 Class I: Visualization of soft palate, fauces, uvula, anterior and posterior tonsillar pillars.
􏱱 Class II: Visualization of soft palate, fauces, uvula.
􏱱 Class III: Visualization of soft palate, base of uvula.
􏱱 Class IV: Nonvisualization of soft palate.

Question 3

Goldman’s risk assessment ?

Answer 3

• Goldman’s risk assessment for cardiac risk for noncardiac surgery.
• Class I: 0-5
• Class II: 6-12
• Class III: 13-25
• Class IV: >25

Question 4

Postoperative complications categories ?

Answer 4

• 10% of all surgical patients.
• Immediate (first 24h)
• Early (2-3 weeks after operation)
• Late (occurring after discharge)

Question 5

Immediate (0–24 hrs) complications ?

Answer 5

• Primary hemorrhage.
• Basal atelectasis.
• Shock (blood loss, MI, PE).
• Oliguria.

Question 6

Early (2 days to 3 weeks) complications ?

Answer 6

􏱱 Mental status changes due to electrolyte imbalance, dehydration, and sepsis.
􏱱 Nausea and vomiting: Analgesia or anesthesia related; paralytic ileus.
􏱱 Fever.
􏱱 Secondary hemorrhage (infection).
􏱱 Pneumonia.
􏱱 Wound infection.
􏱱 Wound or anastomosis dehiscence.
􏱱 DVT, PE.
􏱱 Acute urinary retention.
􏱱 Urinary tract infection.
􏱱 Postoperative wound infection.
􏱱 Bowel obstruction due to fibrinous adhesions.
􏱱 Paralytic ileus.

Question 7

Late (weeks to months) complications ?

Answer 7

􏱱 Bowel obstruction due to fibrous adhesions.
􏱱 Incisional hernia.
􏱱 Persistent sinus.
􏱱 Recurrence of reason for surgery (e.g., malignancy).

Question 8

Haemorrhage management ?

Answer 8

• Relaparotomy.
• Interventional radiology (angiography).
• Blood transfusion.
• Platelet transfusion.
• Fresh frozen plasma (FFP).
• Blood plasma replacements (e.g. Gelofusine® 4%).

Question 9

Temperature between 2-4 day after surgery causes ?

Answer 9

• Intravenous access site infection
• Urinary tract infection (3 day)
• Pneumonia
• Pulmonary embolus

Question 10

Early postoperative temperature causes ?

Answer 10

• Respiratory: Atelectasis. (treat with physiotherpy)

- Systemic response to trauma of surgery.

Question 11

Temperature 5-10 days postoperatively causes ?

Answer 11

• Wound infection
• Wound dehiscence
• Anastomosis dehiscence
• Intraabdominal abscess
• Peritonitis