Chapter 1: Perioperative Eval and Management of Surgical Patients Flashcards
72yo man scheduled to undergo robot-assisted prostatectomy for adenocarcinoma of prostate. PMHx unremarkable and takes no meds. Which one of following is best management to reduce risk of thromboembolic complications?
SubCut LMW Heparin
62yo woman with morbid obesity, DM, HTN, CKD (GFR 55mL/min) undergoes elective right hip replacement under general anesthesia. Which of the following is the primary goal of postoperative fluid management in this patient?
She should be maintained at euvolemia
28yo G1P0 woman who is 20weeks into her pregnancy presents with 2cm hard, nontender mass in upper outer quadrant of her left breast. First noticed mass month b/f learned she was pregnant. Been enlarging over last two months. Which of following is most appropriate recommendation for her?
Excisional bx of mass
42yo man referred for enlarging reducible inguinal hernia. Hx of cirrhosis following hepatitis C. You are trying to assess the level of risk assoc with his liver disease. Components of the MELD score for this patient include?
biliburin, INR and: Creatinine (BIC)
68yo man seen in clinic with reducible right inguinal hernia that is uncomfortable at times. Hx of HTN and suffered uncomplicated ant wall MI that was txed with lytic therapy. Remain on B, statin, and antiplt agent. Regarding hernia repair in this pt, what is the most appropriate way to decrease his risk of cardiac complications?
If possible, surgery should be postponed for 6 months following infarction.
An 82 yo man undergoes screening colonoscopy. Found to have bx proven adenoCa of sigmoid colon. Medical Hx notable for HTN and dilated cardiomyopathy. Which of following findings is most likely to increase his risk of perioperative cadiac omplications?
Audible S3 gallop.
52 yo woman with insulin dependent DM sceudbed to undergo mastectomy with sentianel LN bx at 7:30AM. Perioperative glucose management of this pt is best achieved with:
Half the usual dose of long-acting insulin the morning of surgery (see other indications)
32yo woman presented to ED with incarcerated ventral hernia. Has ESRD and undergoes hemodialysis MWF. Underwent surgery for perforated duodenal ulcer 2ya. PE: tender, nonreducible mass in central portion of epigastric midline incision .Emergency surgery is planned. Which of the following agents is most likely to produce life-threatening hyperkalemia in this pt?
Succinylcholine
72yo man in clinic to discuss Coronary artery bypass grafting. Questions about risks assoc with operation. The term “informed consent” refers to:
The process wherein the pt and surgeon decide on a plan.
You are in Preoperative Eval clinic seeing pts who are scheduled for surgery. Which of the following pts should have preop ECG?
55yo HTNive man being eval for CEA
