Surgery

Question 1

ASA 1

Answer 1

Normal healthy pt

Question 2

ASA2

Answer 2

Mild systemic disease
no substantial functional limitation
e.g. smoker, alcohol, pregnancy, obese, DMHTN well controlled , mild lung disease

Question 3

ASA3

Answer 3

severe systemic disease. substantial functional limitations
poor contolled DM, Ashtma, HTN, COPD, morbid obesity, active hepatitis, alcohol abuse, pacemaker, Moderate reduction of EF, ESRF, MI, CVA

Question 4

ASA4

Answer 4

constant threat to life

recent mI, CVA <3months, ongoing cardiac ischaemia, severe valve dysfunction, severe reduction in EF, sepsis, DIC, ARD, ESRD, not undergoing regularly scheduled dialysis.

Question 5

ASA5

Answer 5

moribund pt not expected to survive wo surgery.

Ruptured AAA
Massive trauma
Intracranial bleed w mass effect
Ischaemic bowel + cardiac pathology
multiple organ dysfunction

Question 6

ASA6

Answer 6

brain dead pt - organs being removed for donor purposes.

Question 7

Ix to check anastamotic leak

Answer 7

Gastrograffin enema

Question 8

Cancer positions, resections and anastamoses.

Answer 8

Caecal, ascending/proximal transcverse colon: right hemicolectomy + ileocolic anastomosis

Distal transverse, descending colon - Left hemicolectomy
-Colo-colon

Sigmoid - high anterior resection (colorectal anast)

Upper rectum (anterior resection (TME) - colorectal anast

Low rectum (anterior resection (Low TME) - colo-rectal +/- defunctioning stoma.

Anal verge - abdominoperineal excision of rectum,