Advanced | Pre-operative Evaluation, Ambulatory Anesthesia, and Office Based Anesthesia Flashcards
ASA for adult on regular hemodialysis:
A. 1
B. 2
C. 3
D. 4
C. 3
A patient with a BMI of 55 presents for middle ear surgery. If Propofol is to be used as an inducting agent, the bolus induction dose for obese should be based on:
A. Lean body weight
B. Total body weight
C. Ideal body weight
D. Ideal body weight + 70%
A. Lean body weight
Lean body weight
IBW = Height - 100
LBW = IBW x 1.3
Breast feeding is contraindicated after receiving which of the following:
A. Codeine
B. Midazolam
C. Paracetamol
D. Tramadol
A. Codeine
In an ambulatory setting, how long would a patient be kept on NPO status if they had consumed a light meal?
A. 4 hours
B. 6 hours
C. 8 hours
D. no need to place them on NPO
B. 6 hours
TRUE or FALSE
ASA III and IV patients can undergo ambulatory surgery as per ASA guideline.
TRUE
Medically stable ASA physical status III or IV patients may be appropriate candidates for ambulatory surgical procedures
A 60 year old male with a significant history of thyroid disorder and hypertension is scheduled for a cataract removal. The following medications should be taken on the day of surgery EXCEPT:
A. beta blockers
B. Antiarrhythmics
C. Diuretics
D. Pulmonary inhalers
E. Hyperthyroid medications
C. Diuretics
Mr. Mamintal is scheduled for ambulatory procedure. He is classified as ASA II for in take of “VAPE”. He is also on several hypertensive medications. Which of the following should be AVOIDED on the day of surgery?
A. ACE Inhibitors
B. Diuretics
C. ARBs
D. Vitamin E
D. All of the above
D. All of the above
- Patients taking supplement like VITAMIN E should be discontinued on the day of surgery. - They have effects of platelets.
TRUE or FALSE
A 10 month old infant with mild URTI can be reasonably operated on in an ambulatory clinic.
FALSE
In the ambulatory clinic, an anxious child oral midazolam of ______ may administered in the preoperative holding area.
A. 0.25mg/kg
B. 1mg/kg
C. 0.1 mg/kg
D. 0.5mg/kg
A. 0.25mg/kg
Barash | 9th edit
Which of the following is MOST accurate pertaining to PDPH after spinal anesthesia?
A. PDPH is believed to result from a loss CSF into the epidural space
B. The symptom is from the decreased hydrostatic pressure in the epidural space causing traction to the meninges
C. Blunt point needles will result to higher incidence
D. Supine position will NOT relieve the symptom
A. PDPH is believed to result from a loss CSF into the epidural space
Barash |9th edit
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This is the most common anesthetic drug used in the ambulatory clinic:
A. Midazolam
B. Propofol
C. Atropine
D. Fentanyl
B. Propofol
This is the most important
factor contributing to a delay in discharge of patients and an increase in unanticipated admissions of both children and adults after ambulatory
surgery.
A. nausea with or without vomiting
B. PONV
C. Post-operative pain
D. Hypersensitivity Reaction
A. nausea with or without vomiting
A 18 year old female, ASA-PS I is scheduled for elective excision of breast mass in your ambulatory clinic. To decrease her chances of developing PONV, the following can be done EXCEPT:
A. Use regional anesthesia alone if possible
B. Use of sugammadex instead of neostigmine
C. Minimize opioids
D. Avoid nitrous oxide
D. Prophylactic steroids
D. Prophylactic steroids
TRUE or FALSE
Neuromuscular blocking agent is a necessary component of endotracheal intubation in the ambulatory clinic.
FALSE
TRUE or FALSE
As per recommendation, ASA II and III physical status is allowed in an office based setting anesthesia, given a hemodynamically stable status.
FALSE
The American Society of Plastic Surgeons acknowledged that
the ideal patient for an office-based procedure has an American Society of Anesthesiology (ASA) physical status of 1 or 2.
According to close claims project, on which phase of the peri-operative period does office-based related injuries most frequently happen?
A. Pre-operative
B. Intra-operative
C. Post-operative
D. After discharge
B. Intra-operative
The Closed Claims Project database reveals that injuries during office based procedures occur throughout the perioperative period and are multifactorial in etiology. The majority, 64%, occurred intra-operatively,
while 14% occurred in the post-anesthesia care unit (PACU) and 21% after discharge
In an office-based procedure, patients with OSAS should receive at least ____ of PACU observation before discharge.
A. 6 hrs
B. 12 hrs
C. 3 hrs
D. 2 hrs
C. 3 hrs
The ASA recommends that patients with OSAS undergoing ambulatory surgery receive at least 3 hours of postoperative observation before discharge to ensure adequate
recovery and minimize airway compromise.
As per ASA recommendation, The following conditions/disease states are unsuitable candidates for an office based procedure EXCEPT:
A. NPO less than 8 hrs
B. No escort home
C. Severe OSAS
D. Poorly controlled DM
E. History of crustacean allergy
E. History of crustacean allergy
You are about to conduct an anesthesia to a 30 year old obese patient in an office-based anesthesia clinic. You plan to give proton pump inhibitor and histamine-2 blocker to lower the risk of gastric content aspiration. The dose of the medications you plan to give preoperatively should be based on:
A. LBW
B. Actual body weight
C. Ideal body weight
D. Predicted body weight
C. Ideal body weight
In general, an office liposuction should be limited to ___ mL of total aspirant which includes supernatant fat and fluid:
A. 1,000 ml
B. 2,000 ml
C. 5,000 ml
D. 500 ml
C. 5,000 ml
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