Lecture 2

Question 1

What is the Goldman’s Criteria

Answer 1

criteria used to determine cardiac risk in non-cardiac procedures

Question 2

What does the Goldman’s Criteria include

Answer 2

Evidence of CHF on exam (JVD, S3) decompensated
MI = 6 mo

Class IV (>25 points) 22% risk

Question 3

Pulmonary Risks include

Answer 3

obesity, advanced age, smoking

Question 4

Cardiac Risks include

Answer 4

previous MI 
CHF
arrhythmia
aortic stenosis
>70 yrs old

Question 5

Pt’s BUN and Cr are elevated. How damaged is the kidney?

Answer 5

at least 75-90% compromised

Question 6

Child’s Classification

Answer 6

risk of mortality in a patient with cirrhosis who undergoes non-cardiac surgery

Question 7

What does Child’s Classification measure

Answer 7

"A BEAN"
ascites
bilirubin 
encephalopathy 
Albumin
nutritional status

Class C–> 50% mortality

Question 8

Hepatic Dysfunction: failure to clear ammonia

Answer 8

> 150 ng/dl –> 80% mortality

albumin <2.0

Question 9

Hemostatic risk is best determined by

Answer 9

HISTORY

Question 10

Shock

Answer 10

condition of cellular metabolic dysfunction secondary to inadequate oxygen delivery resulting from diminished tissue perfusion

Question 11

neurogenic shock

Answer 11

result of spinal injury–> results in bradycardia

Question 12

Goal BP in shock resuscitation

Answer 12

> 90 mm Hg SYSTOLIC

Question 13

How much urine output is acceptable?

Answer 13

1/2 cc/kg/hr

Question 14

When should you expect a post op patient to start producing full amounts of urine

Answer 14

Post-Op day 3

Question 15

Normal Saline

Answer 15

154 meq Na + 154 meq Cl

too much can lead to acidosis

Question 16

Lactate Ringer

Answer 16

130 meq Na + 110 meq Cl + 28 meq lactate + 4 meq K + 3 meq Ca

too much can lead to alkalosis

Question 17

hypotonic solution

Answer 17

77 meq Na + 77 meq Cl

good for maintenance hydration

Question 18

How much IV fluid to give (maintenance)

Answer 18

100/50/20 (24 hour period)
100 ml/ kg for 1st 10 kg
50 ml/ kg for next 10 kg
20 ml/ kg for remaining kg

Question 19

How do you evaluate fluid status?

Answer 19

URINE OUTPUT 
BP 
HR
ins/outs
daily weight 
elevated Hct/Cr
pt complains of thirst

Question 20

which is the first pulse lost w/ hypovolemic patient?

Answer 20

radial pulse