Surgery

Question 1

Herbal supplements which may increase bleeding time

Answer 1

E4G’s

• Vitamin E
• Feverfew
• Garlic
• Ginger
• Ginseng
• Ginko Biloba

Question 2

Drugs which may increase bleeding time

Answer 2

WANACA

• Warfarin
• ASA
• NSAID’s
• Alcohol
• Chemotherapeutics
• Abx

Question 3

Mnemonic DRUGS

Answer 3

DRUGS

• Doctor prescribed
• Recreational
• User prescribed (OTC)
• Gynecological (OCP)
• Sensitivities (Reactions)

Question 4

Indications for Preop CBC

Answer 4

• S/S of anemia

- Anticipated large volume blood loss preoperatively

Question 5

Indications for Preop electrolytes

Answer 5

Warfarin - Potassium abnormalities

Digoxin - Toxicity

Question 6

Indications for Preop creatinine level

Answer 6

• All patients >40
• Perioperative nephrotoxic drugs such as; contrast dye
• Intraoperative hypotension expected
• Cross clamping of the Aorta

Question 7

Indications for Preop CXR

Answer 7

• Possibly those >60

- Anyone with cardiac or pulmonary disease

Question 8

Indications for Preop spirometry

Answer 8

ACP recommends those undergoing

• Thoracic procedure
• Upper abdominal procedures
• Uncontrolled pulmonary disease

Question 9

Perioperative heparin dosing

Answer 9

5000 units SC q12 hrs, until PT is fully ambulatory

Question 10

Perioperative Enoxaprin dosing

Answer 10

40 SQ QD until pt is fully ambulatory

Question 11

Enoxaprin is recommended over heparin in which cases

Answer 11

• Trauma

- Pt’s with abdominal or pelvic cancer