Exam (elaborations)
Surgery Rotation exam with verified answers
- Course
- Institution
Surgery Rotation exam with verified answers
[Show more]
Content preview
Surgery Rotation exam with verifiedanswers
how do you assess perioperative cardiac risk? - .......🔷ANSWERS🔶......✔✔ American College of
Cardiology (ACC) / American Heart Association (AHA):
Major risk-
1) unstable/severe angina
2) MI within past week-month
3) decompensated CHF
4) sig arrhythmias
5) severe valvular dz
Intermed risk-
1) mild angina
2) previous MI
3) compensated CHF
4) DM
Minor risk-
1) adv age
2) abnl ECG
3) nonsinus rhythm (afib)
4) exercise intol
5) smoking hx
6) uncontrolled HTN
classify the cardiac risks for noncardiac surg proc - .......🔷ANSWERS🔶......✔✔ High risk-
1) emergent maj operations in elderly
2) aortic reconstr
,3) maj periph vasc proc
4) proc w maj fluid shifts or blood loss
Intermed risk-
1) carotid endarterectomy
2) maj head/neck resections
3) laparotomy
4) thoracotomy
5) maj orthopedic proc
6) open prostatectomy
Low risk-
1) endoscopy
2) breast proc
3) cataract extraction
how do you categorize anesthesia risk? - .......🔷ANSWERS🔶......✔✔ American Society of
Anestheiologists (ASA):
class 1 - nl healthy pt
class 2 - pt w mild systemic dz and no functl limitations
class 3 - pt w mod-sev systemic dz w some functl limitations
class 4 - pt w sev systemic dz; const threat to life and functl incapac
class 5 - moribund pt who is not expected to survive 24 hrs w/wo surg
class 6 - brain-dead pt whose organs are being harvested
class E - proc is an emergency
what are the adv/disadv of local, spinal and general anesthesia? - .......🔷ANSWERS🔶......✔✔ local -
fewer phys conseq; may fail to provide good anesthesia, causing incr pain that needs to be offset with
large doses of IV sedatives, which incr risk
spinal - fewer pulm conseq, but more dangerous in pts w CAD, marginal cardiac reserve w low EF,
valv heart dz, or diab periph neurop due to loss of periph vasoconstr ability or ability to incr CO
, when necessary; HYPOTENSION may result, which needs to be stabilzed by IV drugs, which incr
risk; may fail to provide good anesthesia, causing incr pain that needs to be offset with large doses of
IV sedatives, which incr risk
general - excellent analgesia and amnesia, maintains good phys control; incr incidence of pulm
complications and mild cardiodepression
how do you surg assess/proceed for a pt taking aspirin/NSAIDs? - .......🔷ANSWERS🔶......✔✔
(blood thinners); aspirin and NSAIDs cause platelet dysfunction due to inhib COX, preventing PG
synthesis;
aspirin irrev affects platelet aggregation for 7-10 days; d/c 7-10 days before elective surg
NSAIDs rev affect platelet aggregation for 2 days; d/c 2 days before elective surg
how do you surg assess/proceed for pt w elev serum choles? - .......🔷ANSWERS🔶......✔✔ incr risk
CAD, but as a single factor, doesn't postpone surg
how do you surg assess/proceed for a pt whose ECG shows evidence of previous MI?
- .......🔷ANSWERS🔶......✔✔ cardiology consult, exercise stress test, eval signs of ischemia, cardiac
cath, may need coronary revasc
how do you surg assess/proceed for a pt w DM? - .......🔷ANSWERS🔶......✔✔ NPO after midnight;
IVF w dex drip; do not give hypogly meds morning of surg; if pt's serum glu is >250, give 2/3
morning dose of NPH/insulin and postpone surg until serum glu is under control (100-250); if pt's
serum glu is <250, give 1/2 morning dose of NPH/insulin; watch for infxns
how do you surg assess/proceed for a pt w low hematocrit (34%)? - .......🔷ANSWERS🔶......✔✔ surg
needs to be postponed for anemic pts; determine cause of anemia (MC colorectal CA or GI blood
loss)
how do you surg assess/proceed for a pt w high hematocrit (55%)? - .......🔷ANSWERS🔶......✔✔
most likely due to hypovolemia or polycythemia; postpone surg until pt is well hydrated; eval cause
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Fordenken. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $16.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
62890 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now