The Surgical Patient

Question 1

How long should aspirin be held before surgery

Answer 1

7-10 days

Question 2

How long should insulin be held before surgery

Answer 2

Give half dose day of surgery

Question 3

Ideally, when should you stop smoking prior to surgery?

Answer 3

8 weeks

Question 4

Classification system that predicts difficulty of intubation

Answer 4

Mallampati

Question 5

High risk procedures for developing DVT or PE

Answer 5

• Long surgery
• Orthopedic
• Pelvic
• Abdominal cancer surgery

Question 6

Most common complication of dialysis patients

Answer 6

hyperkalemia

Question 7

What are ways to treat hyperkalemia?

Answer 7

• IV calcium gluconate
• D50 + insulin
• Bicarbonate
• Albuterol
• Kayexalate (binds to K+ in the GI tract)

Question 8

What labs/tests need to be checked prior to surgery?

Answer 8

• CBC
• Type and cross
• Coagulopathy (PT, PTT
• BUN and creatinine
• CXR
• UA
• ECG
• beta- HCG

Question 9

At what platelet level do we start to be concerned about excessive surgical bleeding?

Answer 9

50,000

Question 10

How much does one unit of platelets raise count?

Answer 10

5,000 - 10,000

Question 11

Which is the go to antibiotic preoperatively?

Answer 11

Cefazolin (Ancef)

Question 12

If the patient can’t take Ancef, what is a good replacement?

Answer 12

Clindamycin

Question 13

When should patient’s be NPO before surgery?

Answer 13

NPO after midnight the night prior to surgery

Question 14

When should ABO prophylaxis be given prior to surgery?

Answer 14

30 min prior to skin incision

Question 15

Who needs an ECG prior to surgery

Answer 15

• > 35 years

- Any cardiac hx