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3rd Year Medical Specialties > Anaesthetics - Pre-op assessment > Flashcards

Anaesthetics - Pre-op assessment Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the main traumas of surgery?

A

Stress response
Fluid shifts
Blood loss
CVS, Resp, renal and metabolic stress

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2
Q

What must be considered in a Pre-op assessment?

A 
Patient morbidities
Infection markers
Nature of surgery 
Anaesthetic techniques
Post-op care levels 0-3
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3
Q

What are the Anaesthetic post-operative care levels?

A

0 - ward
1 - ward with assistance
2 - HDU
3 - Ventilation on ITU

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4
Q

What is the role of the anaesthetist in Pre-op assessment?

A

Assess patient
Identify high risk, minimise it
Support and inform patient
Gain consent

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5
Q

What are the benefits of Pre-op assessment?

A

Reducing anxiety, delays, cancellations, complications and length of stay

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6
Q

What is asked in a history for Pre-op assessment?

A

Known comorbidities
Hx and examination for unknown comorbidities
Exercise tolerance
Cardio-respiratory disease

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7
Q

What factors could suggest anaesthetic problems in a patient history?

A 
Airway
Spine
Reflux
Obesity
Malignant hyperpyrexia
Cholinesterase deficiency
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8
Q

What cardiovascular investigations can be used for Pre-op assessment?

A 
ECG
ETT
Echo
Myocardial perfusion
CT coronary angiogram
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9
Q

What respiratory investigations can be used for Pre-op assessment?

A 
Saturations
ABG
CXR
Lung function tests
Peak flow
Gas transfer
CT chest
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10
Q

What is the role of investigations in Pre-op assessment?

A

Test sensitivity

Target at-risk patients

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11
Q

What is ASA grading?

A

1 - Otherwise Healthy patient

6 - Organ retrieval

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12
Q

What are the factors in the Cardiac risk index?

A 
High risk surgery
Ischaemic Heart disease
CHF
Diabetes
Renal failure
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13
Q

Which conditions, if found on Pre-op assessment, require optimised control?

A 
HTN
Ischaemic heart disease
HF
Asthma
COPD
Diabetes 
Epilepsy
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14
Q

What lifestyle factors increase patient risk in operations?

A

Smoking
Alcohol
Obesity
Lack of exercise

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15
Q

What can be done to improve outcomes for patients pre-surgery?

A

Pre-habilitation exercise

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16
Q

What medications change in pre-op management?

A 
MUST continue:
Inhalers
Anti-anginals
Anti-epileptics
STOP:
Anti-diabetic mediation
Anticoagulants

3rd Year Medical Specialties (18 decks)

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