31. Preoperative assessment Flashcards
VPB and surgery
Proceed if < 30, cardiologist if >30
Afib and surgery
Cardiologist if HR >100
When ACTH higher in surgery
At the end of anesthesia
Where is cortisol released?
Adrenal cortex
MEN 1
MEN 2
MEN 1. 3P. Pituitary, Parathyroid, Pancreas
MEN 2. Pheochromocytoma, Parathyroid, Thyroid
Pheochromocytoma characteristics
Sweating, Headache, Tachycardia
BMI predictor of difficult ventilation
BMI > 26
ARISCAT values
< 26 risk 1.6%
26-44 risk 13.3%
> 45 Risk 42.1%
When contrast induced nephropathy occurs
Increase of Creat 24-48 hours after
CHA2DS2 VASc
CHF
HT
Age > 75
DM
Stroke
Vascular
Age (64-75)
Female
Severe Aortic Stenosis
MP gradient > 40
Speed > 4
< 1 cm
RCRI index
Values
High risk surgery
IHD
CHF
CVA
DM + Insulin
Creat > 2
RCRI index risk
0 — 0.4%
1 – 1%
2 – 2.4%
3 or more – 5.4%
MET if the patient can climb one floor of stairs
MET 5
Stop dabigatran
48 hours
If GFR low 96h