Lecture 1 practice questions

Question 1

Which is NOT one of the 3 primary review of systems categories that should be done before every surgery? (important)
a) Cardiovascular
b) Pulmonary
c) Neurologic
d) Gastrointestinal

Answer 1

d) Gastrointestinal

Question 2

What is the best option for peri-operative glucose control? (important)
a) IV insulin
b) PO metformin
c) IM insulin
d) IV metformin

Answer 2

a) IV insulin

Question 3

___________ therapy prolongs PT/INR, whereas __________ therapy prolongs aPTT

Answer 3

Warfarin; heparin

Question 4

Name a direct thrombin inhibitor

Answer 4

Dabigatran

Question 5

What is the most common surgical infection in surgical ICUs?

Answer 5

Pneumonia

Question 6

Which is incorrect about preoperative tests?
There is no “routine” battery of preoperative tests for all patients
a) You should generally get a CBC on all females >12 y/o
b) An EKG would be justified in any woman over 50
c) You should generally get a CMP and blood glucose test for diabetic patients
d) Premenopausal females over the age of 9 with a uterus should have a pregnancy test done

Answer 6

b) An EKG would be justified in any woman over 50

(justified in any man >50 or woman >60)

Question 7

A delay of >1-6 weeks before performing a __________ operation will negatively affect outcome
a) Urgent
b) Elective
c) Emergency
d) Time-sensitive

Answer 7

d) Time-sensitive

Question 8

What classification system predicts how well patients might tolerate operations? (important)
a) American Society of Anesthesiologists (ASA)
b) Acute Physiology and Chronic Health Evaluation (APACHE II & APACHE III)

Answer 8

a) American Society of Anesthesiologists (ASA)

(APACHE II & APACHE III estimate ICU severity)

Question 9

Which is incorrect regarding risks prior to surgery?
a) Generally continue taking beta blockers if used for maintenance
b) Generally continue taking ASA if used for maintenance
c) Elective surgery should be postponed at least 60 days post-MI
d) ARISCAT score on MDCalc is used to assess pulmonary risks
e) The goal BG for DM patients pre and post-op is <180

Answer 9

b) Generally continue taking ASA if used for maintenance

(only continue if mod-high risk for CAD & risk of hemorrhaging doesn’t outweigh benefit)

Question 10

Which of the following are correct? Select all that apply
a) ESRD pts should receive dialysis 24-36 hrs before operations
b) Albumin <3.0 g/dL is an independent risk factor for SSIs
c) All adrenal insufficiency pts should receive >3wks of >20 mg prednisone daily or >2g/day topical steroid prior to surgery
d) Avoid CT with contrast in patients with large goiters

Answer 10

All are correct

Question 11

T/F: Patients involuntarily committed for mental illness still require informed consent for surgeries

Answer 11

True

Question 12

According to the ASA, prior to surgery:
Avoid clear liquids for at least ___ hours before, light meals at for least ___ hours, and fatty meals for at least ___ hours

Answer 12

2; 6; 8