Peroperative Assesment1

Question 1

Define preoperative care& enumerate phases of perioperative care??

Answer 1

1-term used to describe entire operative span, what occure before, during, after actuall operation.
2- pre-operative
Intra- operative
Post-operative

Question 2

Pre operative begin…………….. Until……………….

Answer 2

With the decision to perform surgery

Reaching operative room

Question 3

Intra operative includes………………. Until the cleint reach…………….

Answer 3

Entire duration of surgical procedure

Recovery area

Question 4

Postoperative begin with……………. Until…………..

Answer 4

Admession to recovery area

Follow up evaluation at home, rehabilitation unit

Question 5

Enumerate goals of pre operative assesment?

Answer 5

1-asses fitness for anaesthesia
2- optimizing patient physical condition to surgery and anaesthesia.
3-allay fear and anxiety
4-permedication
5-establish preoperative fasting
6-provide apperopriate information to patient, obtain consent.
7-further investigations, consultaions, treatment of patienrs not yet optimized.

Question 6

Enumerate phases of preoperative assesment?

Answer 6

1-History
2-physical examination
3-ñeroperative investigation

Question 7

Clarefy what u know about peroperative history?

Answer 7

1-history of present illness and reason of surgery.
2-medical condition(acute or chronic).
3-allergy
4-substance use: alcohol, street drugs, tobacco
5-drug use
6-past medical history
7-past hospitalization and surgeries
8-past problems with anaesthesia
9-family history ( hereditary diseases& problem with anaesthesia
10- review of system

Question 8

Clarefy problems can anti-hypertensive drugs do?

Answer 8

1-ACEIS»»»sever hypotention during induction
2-B Blocker»»-ve inotropic additive to anaesthesia
3- Ca Blocker»> - ve AV confuction & excitability
4- Digoxin&raquo_space;»> toxicity during hypokameia (should corrected pre)
5-Diuretics&raquo_space;»> hypokameia & potentiate MS relaxant

Question 9

Anti-convulsant!

Answer 9

MAOIS»»»with opioids(pethedine) cause coma and convulsions.

Question 10

Mechanism of Tricyclic A. D to cause arrythmia?

Answer 10

Inhibit cate. Metabolism

Question 11

Antibiotics ( Aminoglycosides) potentiate what?

Answer 11

NM excitability

Question 12

Enumerate drugs potentiate action of MS relaxant?

Answer 12

Duretics

Magnesium

Question 13

Enumerate drugs cause bleeding and its mechanism or effect?

Answer 13

1-NSAI&ASPIRIN»>interfer with platlet function&coagulation mech.
2-anticoagulant»» bleeding in minor trauma & interfere with surgery homeostasis

Question 14

Why u should take history of smoking?

Answer 14

1-nicontine effect( HPT&TACHYCARDIA)
2-vascular diseases(peripheral, cerebral, coronary)
3-increase co hemoglobin, dscrease o2 delivery to tissue.
4-lung carcinoma,
5-six fold increase risk of post operative respiratory morbidity.
6- stop smoking 6 weeks before surgery ot at least 12 hours before.

Question 15

Define peroperative physical examination?

Answer 15

Full medical examination should performed primarly by surgeon and documented in patients record
Anasthesiologist should emphasis on CardioVascular, Pulmonary, airway examination and other relative findings.

Question 16

Enumerate: General examination?

Answer 16

1-Nutritional state
2-fluid balance
3-state of skin & mucous membrane(anemia, perfusion, jaundice)
4-Temp

Question 17

Enumerate local examinations should performed pre operative?

Answer 17

Cardiovascular
Respiratory
Air way
Nervous
Skeletal

Question 18

Cvs examination??

Answer 18

1- dyspnea, fatigue, chest pain
2-lower limb edema
3-neck vein
4-pulse( Rate, rythm, volume)
5- carotud bruites

Question 19

Respiratory examination?

Answer 19

Tracheal shift
Cough, tachypnea, cyanosis(peripheral and central)
Ascultation of all lung fields

Question 20

Airway examination???

Answer 20

Teeth( dentures, loose teeth, protruding upper incisors)

Predict diffults in airway( ventillation of endotracheal intubation)

Question 21

Nervous examination??

Answer 21

Document
1- level of conscousness
2- peripheral or cranial nerves lesion

Question 22

Pre operative investigations guided by?

Answer 22

History
Clinical examination
Type of surgery
Age
Gender

Question 23

Enumerate preoperative investigation?

Answer 23

CBC
ECG
URINE ANALYSIS
FBG
RENAL FUNCTION TEST
LIVER FUNCTION TEST
CHEST X RAY
COAGULATION PROFILE

PULMONARY&ABG
PREGNANCY

Question 24

When should patient perform CBC??

Answer 24

1- male>50 years
2- all adult females
3- anemia
4-hemoglobiopathy
5-CVD
6-Major surgeries
7-blood surgery

Question 25

Major surgeries require…..

Answer 25

Group and screening
Or
Cross and match

Question 26

What test is routine for all patients before surgery??

Answer 26

Urine analysis

Question 27

When should perform FBG?

Answer 27

D. M

Steroid therapy

Question 28

Renal function tests include?

Answer 28

Urea
Creatinine
Electrolytes

Question 29

Who should performe renal function test?

Answer 29

>65
\+ve urin analysis
Renal, liver diseases
Malnutrion
Dehydration
DM
Adrenal, pituitary or vascular disease
Drugs( steroids, anti-hypertensive, digoxin, diuretics and other drug therapy affect electrolytes)

Question 30

ECG????

Answer 30

>50 yrs
Smoker>45 yrs
CVD and DM
PULMONARY DISEASE
Drugs act on CVS AND DIURETICS

Question 31

Liver function test?

Answer 31

Alcoholism
Hepatitis
Liver disease
Malnutrion

Question 32

Coagulation profule includes

Answer 32

INR, APTT

Question 33

Coagulación profile test performed to…..

Answer 33

History of bleeding disease
Liver disease
Drug abuse
Anticoagulant drugs

Question 34

Liver disease patients require what investigations?

Answer 34

Renal function test
Liver function test
COAGULATION PROFILE

Question 35

DM REQUIRE

Answer 35

Renal function test

ECG

Question 36

Chest X RAY

Answer 36

All>60
CVD
PULMONARY DIS
THYROID ENLARGMENT( thoracic inlet x ray)

Question 37

Pulmonary function test&ABG??

Answer 37

COPD&asthmatic patients

Elective thoractomy

Question 38

Pregnancy with HCG?

Answer 38

And women in reoroductive age