PreOp

Question 1

Familial history can detect which condition?

Answer 1

Malignant Hyperthermia

Question 2

BMI Ranges:
Underweight
Normal
Overweight
Obese

Answer 2

Underweight: <18.5
Normal: 18.5-24.9
Overweight: 25-29.9
Obese >30

Question 3

2 Anesthesia Hard Stops

Answer 3

Unstable Chest Pain
Decompensated Heart Failure

Question 4

2 Most Important Physical Examination Questions?

Emergent Physical Examination A.M.P.L.E. meaning ?

Answer 4

Allergies and Medications

Allergies, Medications, PMH, Last meal eaten, Event leading to surgery.

Question 5

Which court case established practice of informed consent?

Answer 5

Salgo v. Leland Stanford Jr. University Board of Trustees

Question 6

Common causes of anaphylaxis? (3)

Answer 6

Rocuronium (muscle relaxant), antibiotics, chlorhexidine

Question 7

Do not combine MAOIs with which 2 drugs?

Answer 7

Demerol / Meripedem
Ephedrine

Question 8

Risks of:
Garlic
Ginger
Gingko
Ginseng
Green Tea

Answer 8

bleeding

Question 9

Risks of:
Ephedra
Kava
Saw Palmetto
St. Johns Wort

Answer 9

Ephedra: MI, dec catecholamines
Kava: dec sedation
Saw Palmetto: bleeding
SJW: CYP450

Question 10

NPO Fasting Guidelines for:
Full Meal
Light Meal
Breast Milk
Clear Liquids

Answer 10

Full Meal: 8
Light Meal: 6
Breast Milk: 4
Clear Liquids: 2

Question 11

Some Problems encountered with __ pts:
Parkinson
Lupus
Raynaud

Answer 11

P: medication interactions with Parkinson meds
Lupus: chronic renal insufficiency
Raynaud: monitor O2, comfort b/c cold

Question 12

Challenging Anesthesia Specific Patient Groups (4)

Answer 12

Children, Pregnant pts, breast feeding, elderly

Question 13

Which surgeries are
Low Surgical Risk Procedures? (7)

Answer 13

Cataract, Endoscopic, Skin, Breast, Orthopedic, Ambulatory, Urologic

Question 14

Which surgeries are
Intermediate Surgical Risk (4)

Answer 14

Head/neck surgery
Carotid endarterectomy
Intrathoracic surgery
Intraabdominal surgery

Question 15

Which surgeries are
High Surgical Risk (2)

Answer 15

Aortic and Major Vascular
Peripheral Vascular

Question 16

How many METs are sufficient for Functional Capacity?
What are METs?

Answer 16

> 4 METs
Metabolic Equivalent of Task

Question 17

Briefly Describe ASA w/ disease examples:
I
II
III

Answer 17

I: healthy Patient
II: mild disease w/o limitations; smoker, pregnant, drinker
III: Moderate disease w/ limitations; COPD, hepatitis, pacemaker

Question 18

Briefly Describe ASA w/ disease examples:
IV (4)
V (2)
VI

Answer 18

IV: Recent MI, CVA, CAD, TIA
V: Massive Trauma, Intracranial bleed
VI: brain dead organ donor

Question 19

Which Labs should be ordered for:

ASA-PS 3 or 4 undergoing intermediate risk? (4)
ASA-PS 2, 3, 4 undergoing major procedures (2)

Answer 19

3 or 4: CBC/Hgb/Hct, Renal Function Test, Coagulation, ECG
2, 3, 4: Renal Functioning Test, ECG

Question 20

List common causes of anaphylaxis:
2 Antibiotics
Local Anesthetic (and why)

Answer 20

PCN and cephalosporins
Ester due to preservative PABA (para-aminobenzoic acid)

Question 21

Why is it important to monitor how long patient has been taking prednisone?

Answer 21

High exogenous glucocorticoids suppress cortisol secretion at HPA Axis. This may blunt normal cortisol hypersecretion during surgery.

Question 22

What is PONV?
What are risk factors for it? (4)

Answer 22

Premedication Nausea and Vomiting Prevention
Female, History of PONV, Nonsmoker, PostOp Opioids