Chapter 10 - Preparation for surgery Flashcards
What increases the chance of complications in surgeries?
A) Shorter procedures B) Emergency surgeries performed at night C) Use of robotic techniques D) Surgeries with minimal invasiveness
B) Emergency surgeries performed at night
Why are neonatal animals at higher risk during anesthesia?
A) They are immunocompetent B) They have compensatory mechanisms C) They lack energy stores and compensatory mechanisms D) Their organs are fully developed
C) They lack energy stores and compensatory mechanisms
Which animals are at higher risk of developing postoperative rhabdomyolysis?
A) Small animals B) Obese animals C) Large and heavy animals D) Neonatal animals
C) Large and heavy animals
Which classification system is used to assess the physical status of patients?
A) POSSUM B) MODS C) ASA D) SMOOS
C) ASA
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What does the MODS system assess?
A) Anesthesia risks B) Multiple organ dysfunction syndrome C) Preoperative nutrition status D) Recovery time
B) Multiple organ dysfunction syndrome
What percentage of surgical complications are caused by technical provider-related errors?
A) 20-30% B) 47-96% C) 15-50% D) 60-80%
B) 47-96%
What is the definition of physical status I? Prognosis?
Healthy with no organic disease. Excellent
What is the definition of physical status II? Prognosis?
Local disease with no systemic signs. Good
What is the definition of physical status III? Prognosis?
Disease causes moderate systemic signs that limit function. Fair
What is the definition of physical status IV? Prognosis?
Disease causes severe systemic signs and threatens life. Guarded
What is the definition of physical status V? Prognosis?
Moribund, not expected to live for more than 24 hours with or without surgery. Grave
What is the definition of physical status E? Prognosis?
The addition of “E” in any of the above classes denotes Emergency surgery: An emergency is defined as existing when delay in treatment of the patient would lead to a significant increase in the threat to life or body part. Variable.
What are the recommended Laboratory tests MINOR in physical status I and II?
PCV, TP, urine specific gravity
Which condition in horses is linked to higher mortality rates when classified under ASA?
A) Colic B) Laminitis C) Fractures D) Respiratory issues
A) Colic
What increases the chances of perioperative fatalities in horses?
A) Low ASA classification B) High ASA classification C) Routine surgeries D) Daytime surgeries
B) High ASA classification
How much more likely is mortality in colic patients compared to healthy ASA-I animals?
A) 2 times B) 10 times C) 12 times D) 20 times
C) 12 times
hich is a primary determinant of surgical risk in animals?
A) Nutritional status B) Time of surgery C) Size of the surgical team D) Type of anesthesia
A) Nutritional status
Which type of surgery tends to have more complications due to lack of specialized training?
A) Routine procedures B) Advanced procedures C) Emergency surgeries D) Minimally invasive surgeries
B) Advanced procedures
What factor is a key consideration for reducing routine surgical errors?
A) Strict adherence to protocols B) Continuous surgeon education C) More advanced surgical tools D) Increased postoperative care
B) Continuous surgeon education
How are better surgical outcomes related to the number of surgeries performed?
A) More surgeries lead to worse outcomes B) Higher volume of procedures by specialized surgeons leads to better outcomes C) Less frequent surgeries are safer D) There is no correlation between volume and outcomes
B) Higher volume of procedures by specialized surgeons leads to better outcomes
What was the mortality rate associated with healthy ASA-I class horses?
A) 0.1% B) 0.3% C) 1.0% D) 3.6%
B) 0.3%
What kind of animals are predisposed to post-surgical infection due to malnutrition?
A) Large animals B) Neonatal animals C) Cachectic animals D) Healthy animals
C) Cachectic animals
Which animals are at risk for hyperlipemia after surgery?
A) Donkeys and obese animals B) Large and healthy animals C) Elderly animals D) Small animals only
A) Donkeys and obese animals
What type of error contributes to most deaths in small intestinal colic cases?
A) Equipment failure B) Technical and judgment errors C) Delayed diagnosis D) Lack of anesthesia
B) Technical and judgment errors
Which of the following decreases postoperative recovery smoothness in horses?
A) Good cardiovascular condition B) Hypotension during surgery C) Stable nutritional status D) Fast surgery completion
B) Hypotension during surgery
Which surgical complication is more frequent in larger animals?
A) Postoperative herniation B) Hypoglycemia C) Hemorrhage D) Reduced wound healing
A) Postoperative herniation
What is the primary risk factor for increased morbidity and mortality in surgeries?
A) Type of anesthesia used B) Surgical technique C) Duration of the procedure D) Size of the animal
C) Duration of the procedure
What condition in equine surgery is associated with long surgical duration?
A) Tachycardia B) Bradycardia C) Hypertension D) Hyperthermia
B) Bradycardia
What is an appropriate patient preparation time for equine surgery?
A) 10 minutes B) 30 minutes C) 60 minutes D) 90 minutes
B) 30 minutes
What risk factor increases the likelihood of SSI in horses with pituitary pars intermedia dysfunction (PPID)?
A) Delayed wound healing B) Increased susceptibility to anesthesia C) Poor blood circulation D) Faster recovery times
A) Delayed wound healing
What is the recommended time for surgeon hand preparation before surgery?
A) 30 seconds B) 1 minute C) 2 minutes D) 5 minutes
C) 2 minutes
What is the risk associated with a 1.5-times increase in creatinine from baseline values post-surgery?
A) Increased risk of SSI B) Risk of post-surgical bleeding C) Risk for acute kidney injury D) Risk of heart failure
C) Risk for acute kidney injury
Why are closed sterile castrations performed in the “dirty” theater?
A) To increase patient safety B) To reduce environmental pressure on the clean theater C) To minimize risk of infection D) To maximize efficiency
B) To reduce environmental pressure on the clean theater
What is the minimum recommended size for a surgical suite?
A) 40 m² B) 50 m² C) 60 m² D) 70 m²
B) 50 m²
What size is considered optimal for a surgical theater to allow safe movement of staff and equipment?
A) 8 m x 7 m B) 9 m x 7 m C) 10 m x 8 m D) 12 m x 10 m
B) 9 m x 7 m
hat should the height of the hoist be to lift an adult Warmblood onto a surgery table?
A) 2 meters B) 3 meters C) 4 meters D) 5 meters
C) 4 meters
How high should the surgical suite ceilings be to minimize air volume and dirt accumulation?
A) High B) Low C) Medium D) Very high
B) Low
What alternative to hoists is suggested for positioning limbs in arthroscopy procedures?
A) Electric hoists B) Sailing ropes attached to the ceiling C) Hydraulic systems D) Manual lifting
B) Sailing ropes attached to the ceiling
What should the height of pulleys for fracture reduction devices be?
A) Waist height B) Shoulder height C) Ceiling height D) Knee height
A) Waist height
What is the optimal room temperature for surgical theaters?
A) 18°C to 20°C B) 20°C to 24°C C) 24°C to 26°C D) 26°C to 28°C
B) 20°C to 24°C
What is the purpose of maintaining low positive pressure in the operating room?
A) To reduce temperature fluctuations B) To prevent entry of contaminated air C) To increase airflow D) To enhance ventilation
B) To prevent entry of contaminated air
What is the recommended number of air exchanges per hour in an operating room with recirculated air?
A) 10 exchanges B) 15 exchanges C) 25 exchanges D) 30 exchanges
C) 25 exchanges
ow many CFUs per cubic meter of air are recommended during a surgical procedure with 10 people present?
A) 10 CFU/m³ B) 50 CFU/m³ C) 100 CFU/m³ D) 500 CFU/m³
C) 100 CFU/m³
What lighting intensity is required for surgical lights in the operating room?
A) 10,000 to 20,000 Lux B) 40,000 to 160,000 Lux C) 100,000 to 200,000 Lux D) 200,000 to 300,000 Lux
B) 40,000 to 160,000 Lux
hy are LED lights preferred for surgical lighting?
A) They are cheaper B) They do not generate heat C) They provide better color contrast D) They are easier to install
B) They do not generate heat
How long can reusable head covers be used before discarding?
A) 100 times B) 75 times C) 50 times D) Indefinitely if cleaned properly
B) 75 times
When should a face mask be replaced during a procedure?
A) Every 4 hours B) Every 2 hours C) At the end of the day D) After visible contamination
B) Every 2 hours
How much time should the effectiveness of masks be relied on during surgery?
A) No more than 4 hours B) No more than 3 hours C) No more than 2 hours D) No more than 1 hour
C) No more than 2 hours
Which factor contributes to increased airborne bacteria in the operating room?
A) Number of people B) Wearing masks C) Minimal talking D) High ventilation
A) Number of people
Which bacterial species are often associated with hair as a major source of contamination?
A) Escherichia coli B) Staphylococcus aureus C) Pseudomonas aeruginosa D) Bacillus subtilis
B) Staphylococcus aureus
Surgical gloves are made from which of the following materials?
A) Cotton
B) Nitrile
C) Nylon
D) Paper
B) Nitrile
What is the primary benefit of nitrile gloves?
A) Superior tactile sensation
B) Latex and protein-free, suitable for allergic individuals
C) High moisture absorption
D) Eco-friendly
B) Latex and protein-free, suitable for allergic individuals
What should be avoided when rinsing gloves during a procedure?
A) Water
B) Alcohol
C) Chlorhexidine
D) Sterile saline
B) Alcohol
What is the recommended glove change interval during surgeries lasting more than 90 minutes?
A) Every 30 minutes
B) Every 60–90 minutes
C) Every 2 hours
D) Only after surgery
B) Every 60–90 minutes
What is the glove perforation rate after surgeries lasting more than 60 minutes in equine surgeries?
A) 5%
B) 10%
C) 27%
D) 40%
C) 27%
Where are glove punctures most commonly found during surgery?
A) Thumb of dominant hand
B) Index finger of nondominant hand
C) Palm of dominant hand
D) Middle finger of nondominant hand
B) Index finger of nondominant hand
What is the recommended placement of gloves during gloving?
A) Just over the wrist
B) Over the gown’s knuckles
C) Over the gown cuff at the knuckles
D) Over the elbow
C) Over the gown cuff at the knuckles
In which type of surgery is glove perforation least likely?
A) Minimally invasive surgeries
B) Orthopedic procedures
C) Suturing procedures
D) Equine celiotomies
A) Minimally invasive surgeries
What should be done to gloves after handling implants during surgery?
A) Discard the gloves
B) Disinfect them with alcohol
C) Replace the gloves
D) Leave them on
C) Replace the gloves
What technique is used to provide clean glove changes during surgery?
A) Open gloving
B) Closed gloving
C) Third-party gloving
D) Self-gloving
C) Third-party gloving
What glove material poses a risk of sensitization due to proteins and chemicals in it?
A) Nitrile
B) Vinyl
C) Latex
D) Neoprene
C) Latex
Footwear used in the operating room can become contaminated with which of the following?
A) Staphylococcus aureus B) Coagulase-negative staphylococci C) Methicillin-resistant Staphylococcus pseudintermedius D) Extended-spectrum β-lactamase-producing E. coli
B) Coagulase-negative staphylococci
What is the risk associated with artificial nails in surgical settings?
A) They harbor fewer bacteria than natural nails B) They cause frequent glove tears C) They enhance proper hand hygiene practices D) They are easier to disinfect than natural nails
B) They cause frequent glove tears
Which of the following microorganisms are significantly more present on artificial nails compared to normal nails?
A) Methicillin-resistant Staphylococcus aureus (MRSA) B) Coagulase-negative staphylococci C) Gram-negative rods D) Yeast species
C) Gram-negative rods
What percentage of mobile phones in hospitals cultured positive for MRSA according to a systematic review?
A) 20% B) 30% C) 40% D) 50%
C) 40%
The use of mobile phones in surgical theaters poses a risk of contamination by:
A) Methicillin-resistant Staphylococcus pseudintermedius B) Extended-spectrum β-lactamase-producing E. coli C) Coagulase-negative staphylococci D) Vancomycin-resistant enterococci
B) Extended-spectrum β-lactamase-producing E. coli
Up to what percentage of stethoscopes are contaminated with MRSA?
A) 15% B) 30% C) 42% D) 50%
C) 42%
Which type of bacteria found on mobile devices is especially relevant in equine medicine?
A) MRSA B) MRSP C) Escherichia coli D) Pseudomonas aeruginosa
A) MRSA
What effect does aggressive cleaning of the skin with medicated soaps like CHX have?
A) It enhances bacterial elimination B) It damages the skin and increases bacterial colonization C) It prevents future infections D) It reduces the need for hand rubbing
B) It damages the skin and increases bacterial colonization
What is a risk associated with the use of scrub brushes for hand preparation?
A) They increase skin moisture B) They increase bacterial load on the skin C) They cause glove tears D) They remove essential skin oils
B) They increase bacterial load on the skin
If hands are visibly soiled before surgery, they should be cleaned with:
A) Antibacterial lotion B) A soft sponge and water C) A disinfectant wipe D) An alcohol-based hand rub (AHR)
B) A soft sponge and water
Which hand preparation solution has been shown to be superior for rapid and effective microbial reduction?
A) CHX soap B) Alcohol-based hand rub (AHR) C) Povidone-iodine (PVP) soap D) Non-medicated soap
B) Alcohol-based hand rub (AHR)
Alcohol-based hand rubs (AHRs) prevent bacterial regrowth to baseline values for how long after application?
A) 3 hours B) 4 hours C) 6 hours D) 12 hours
C) 6 hours
What skin condition is associated with the long-term use of medicated soaps containing CHX?
A) Dermatitis B) Psoriasis C) Eczema D) Skin thickening
A) Dermatitis
Which of the following is recommended to maintain good hand asepsis after using alcohol-based hand rubs?
A) Wearing moisturized gloves B) Using an additional round of scrubbing C) Applying a hand moisturizer to avoid dry skin D) Avoiding hand moisturizers
C) Applying a hand moisturizer to avoid dry skin
Which type of contamination does double-gloving reduce?
A) Resident skin flora B) Transient bacteria C) Environmental contaminants D) All of the above
D) All of the above
What is the major challenge with using alcohol-based hand rubs in operating rooms?
A) They increase glove tearing risk B) They cause more skin irritation C) They evaporate too slowly D) They are ineffective in the presence of organic matter
D) They are ineffective in the presence of organic matter
Which of the following hand antiseptic agents is associated with skin drying?
A) Alcohol-based solutions B) Chlorhexidine gluconate (CHX) C) Povidone-iodine (PVP) D) All of the above
D) All of the above
Studies show CHX formulations retain bacterial suppression for how long?
A) 3 hours B) 4 hours C) 6 hours D) 12 hours
B) 4 hours
What should be used if surgical gloves are compromised during surgery?
A) Alcohol-based hand rub B) Sterile surgical towel C) Immediate glove change D) A new set of foot covers
C) Immediate glove change
What is a major source of undesirable movements during surgery?
A) Noise in the room B) The horse’s reaction C) Filling of the urinary bladder D) The veterinarian's movements
C) Filling of the urinary bladder
Razors can cause substantial injury compared to which methods?
A) Hair removal creams B) Depilation or clipping C) Scissors D) Shears
B) Depilation or clipping
When should clipping occur to reduce infection rates in veterinary patients?
A) The day before surgery B) Immediately before surgery C) Any time before surgery D) Only if the hair is long
B) Immediately before surgery
The clipped area for surgery should extend:
A) Just around the incision B) 5 to 10 cm around the incision C) 15 to 20 cm around the incision D) No extension needed
C) 15 to 20 cm around the incision
What is the recommended tool for clipping in the preparation room?
A) Manual clippers B) No. 40 clipper blades C) Hair scissors D) Disposable razors
B) No. 40 clipper blades
Biocides used for surgical preparation may be ineffective in the presence of:
A) Hair B) Organic debris C) Dust D) Water
B) Organic debris
What is the minimum recommended concentration of CHX for bactericidal activity?
A) 0.5% B) 1% C) 2% D) 5%
C) 2%
How should antiseptic solutions be applied to the surgical site?
A) By scrubbing vigorously B) Using a concentric pattern C) Splashing on D) Wiping with bare hands
B) Using a concentric pattern
What antiseptic is particularly active against MRSA?
A) CHX B) PVP C) Alcohol D) Soap
B) PVP
What is the purpose of cyanoacrylate-based microbial sealants?
A) To reduce bleeding B) To block migration of pathogens C) To improve aesthetic appearance D) To speed up healing
B) To block migration of pathogens
Which of the following draping materials is preferred due to better barrier function?
A) Plastic drapes B) Cotton drapes C) Nonwoven disposable materials D) Woven fabrics
C) Nonwoven disposable materials
What type of drape should not be used due to bacterial growth concerns?
A) Nonwoven drapes B) Plastic drapes C) Paper drapes D) Cotton drapes
B) Plastic drapes
Which surgical drapes are designed to keep the intestine moist when exteriorized?
A) Cotton drapes B) Laparotomy drapes C) Adhesive drapes D) Thyroid drapes
B) Laparotomy drapes
What technique is recommended for double draping?
A) Applying a single layer of drape B) Using a quadrant method C) Wrapping drapes tightly D) Using non-adhesive drapes
B) Using a quadrant method
What should be done to the horse’s tail before procedures near the hindquarters?
A) Leave it loose B) Firmly braid and fold it C) Cut it off D) Braid loosely
B) Firmly braid and fold it
What is the ideal position of the horse’s limbs when in lateral recumbency?
A) Both limbs extended B) Upper limb flexed and lower limb extended C) Both limbs flexed D) Upper limb extended, lower limb folded
B) Upper limb flexed and lower limb extended
