Exam 1

Question 1

What is AMPLE

Answer 1

Emergent Physical Examination
A= Allergies
M= Medications
P= Past Medical History
L= Last meal eaten
E= Events leading up to need for surgery/procedure

Question 2

In an emergency, assume _________ for last meal eaten

Answer 2

8-24hrs full stomach.
sympathetic system causes GI to slow

Question 3

What is the calculation for BMI?

Answer 3

Metric: BMI= weight (kg) /height (m^2)

Imperial: 703 x weight (lbs) /height (in^2)

Question 4

What BMI is underweight

Answer 4

< 18.5

Question 5

What BMI is Normal

Answer 5

18.5-24.9

Question 6

What BMI is Overweight

Answer 6

25.0-29.99

Question 7

What BMI is Obese

Answer 7

30.00 and above

Question 8

What is RCRI

Answer 8

Revised Cardiac Risk Index

Prediction tool recommended by ACC/AHA that estimates risk of cardiac complications after surgery

Question 9

What are the Red Flags?

Answer 9

Bowel/bladder dysfunction
Saddle anesthesia
Bilateral leg weakness
Severe, sudden onset headache
Fever, Weightloss, night sweats - TB, cancer signs
Recent injury
History of cancer

Question 10

Court case that established the practice of informed consent

Answer 10

Salgo v. Leland Standford Hospital

Question 11

Examples of High risk procedures

Answer 11

Aortic and major vascular
Peripheral vascular

Question 12

Examples of intermediate risk procedures

Answer 12

Intraabdominal surgery
Intrathoracic surgery
Carotid endarterectomy
Head/neck surgery

Question 13

Examples of low risk procedures

Answer 13

ambulatory surgery
breast surgery
endoscopic procedures
cataract surgery
skin surgery
urologic surgery
orthopedic surgery

Question 14

Functional capacity is ____

Answer 14

Assessment of cardiopulmonary fitness

Estimates patient risk for major post-op morbidity and mortality

Determines if further testing is necessary

Poor functional capacity= increased Peri-operative risk

Question 15

Functional capacity is measure in ____

Answer 15

METS (metabolic equivalent of task)

rate of energy consumption at rest

1 MET = 3.5mL/kg/min

Question 16

of METs that indicate good functional capacity

Answer 16

> 4 METs

Question 17

Urgency of surgery that is life or limb would be threatened if surgery did not proceed within 6 hours or less

Answer 17

Emergency

Question 18

Urgency of surgery that is life or limb threatened if surgery did not proceed within 6-24hours

Answer 18

Urgent

Question 19

Urgency of surgery where delays exceeding 1-6 weeks would adversely affect patient outcomes

Answer 19

Time-sensitive

Question 20

What is the ASA classification for the following:

Normal healthy patient, non smoker, no alcohol

Answer 20

ASA 1

Question 21

What is the ASA classification for the following:

Patient with mild systemic disease;
examples: current smoker, social alcohol, pregnant, obesity, well-controlled DM, mild lung disease

Answer 21

ASA 2

Question 22

What is the ASA classification for the following:

Patient with severe systemic disease:
ex. Substantial functional limitations, one or more moderate to severe diseases. Poor DM, morbid obesity, COPD, HTN, pacemaker, ESRD on dialysis etc.

Answer 22

ASA 3

Question 23

What is the ASA classification for the following:

A patient with severe systemic disease that is a constant threat to life; recent MI, CVA, TIA, CAD/stents, cardiac ischemia, ARDS, DIC, sepsis

Answer 23

ASA 4

Question 24

What is the ASA classification for the following:

A moribund patient who is not expected to survive without this operation; ruptured abdominal or

Answer 24

ASA 5

Question 25

What is the ASA classification for the following:

a declared braindead patient whose organs are being removed for donor purposes

Answer 25

ASA 6

Question 26

P wave is positive in which leads?

Answer 26

I, II, aVF, V4-6

Question 27

T waves are positive in which leads?

Answer 27

I, II, V3-6