Notes in 18 Preoperative evaluation and medication

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Published	12/13/2023	1 MET = consumption of {{c1::3.5}} mL O2/kg/min
Published	12/13/2023	Sulfonylureas should be discontinued {{c1::24-48 hours}} before surgery.
Published	12/13/2023	A METS (metabolic equivalent of task score) of {{c1::4+}} predicts a {{c2::low}} risk of perioperative complications.
Published	12/13/2023	What three classes of medications can we give to prevent aspiration?{{c1::H2 receptor antagonists}}{{c1::Antacids}}{{c1::Gastric motility agents}}
Published	12/13/2023	Why do patients with acromegaly have a difficult airway?{{c1::Small vocal cord opening}}
Published	12/13/2023	A positive {{c2::prayer}} sign predicts {{c1::cervical spine immobility}} in diabetic patients.
Published	12/13/2023	A class {{c1::A}} mandibular protrusion means lower incisors can be protruded anterior to upper incisors.
Published	12/13/2023	A class {{c1::B}} mandibular protrusion means lower incisors can be brought edge to edge with upper incisors.
Published	12/13/2023	A class {{c1::C}} mandibular protrusion means lower incisors cannot be brought edge to edge with upper incisors.
Published	12/13/2023	Cormack-LehaneGrade 1 - {{c1::full exposure (anterior + posterior commisure)}}
Published	12/13/2023	Cormack-LehaneGrade 2 - {{c1::Anterior commisure not visualized}}
Published	12/13/2023	Cormack-LehaneGrade 3 - {{c1::Epiglottis only}}
Published	12/13/2023	Cormack-LehaneGrade 4 - {{c1::No glottic structures visible}}
Published	12/13/2023	What type of vascular surgeries are considered high risk (on RCRI)?{{c1::suprainguinal vascular}}
Published	12/13/2023	What activities constitute 4 METS?{{c1::Climbing a flight of stairs, walking up a hill, walk on level ground at 4 MPH}}
Published	12/13/2023	Class {{c1::I}} Mallampati airway
Published	12/13/2023	Class {{c1::II}} Mallampati airway
Published	12/13/2023	Class {{c1::III}} Mallampati airway
Published	12/13/2023	Class {{c1::IV}} Mallampati airway
Published	12/13/2023	{{c1::1}} MET(s) = Eating, working at computer, or dressing
Published	12/13/2023	{{c1::4}} MET(s) = Raking leaves or gardening
Published	12/13/2023	{{c1::10}} MET(s) = Jump-roping slowly, running, or jogging briskly
Published	12/13/2023	General anesthetics can cause unrecognized intraoperative {{c1::hypoglycemia}} in patients with diabetes.
Published	12/13/2023	Metformin should be {{c1::held}} the morning of surgery.
Published	12/13/2023	Patients with chronic renal failure should have {{c1::dialysis}} done within 24 hours of surgery
Published	12/13/2023	Pheochromocytoma is caused by a benign tumor of the {{c1::adrenal gland}}, usually arising from {{c2::chromaffin}} cells.
Published	12/13/2023	Pheochromocytomas cause excess secretion of {{c1::catecholamines}}
Published	12/13/2023	The classic presentation of {{c1::pheochromocytoma}} reflects excessive SNS activation, and includes headache, diaphoresis, and tachycardia.&nbsp…
Published	12/13/2023	The glomerular filtration rate (GFR) is best estimated by the {{c1::creatinine clearance}}.
Published	12/13/2023	Hypoparathyroidism causes {{c1::hypocalcemia::electrolyte derangement}}
Published	12/13/2023	When should diabetic patients be scheduled for sugery?{{c1::Early }}
Published	12/13/2023	A drug is considered fully eliminated after {{c1::4-5}} half lives.
Published	12/13/2023	A nonreassuring airway finding would be {{c1::long}} upper incisors.
Published	12/13/2023	{{c1::Polysomnography}} is the gold standard diagnostic test for obstructive sleep apnea.
Published	12/13/2023	A subarachnoid hemorrhage can present with {{c2::fever}} and {{c2::leukocytosis}} as a result of {{c1::meningeal irritation}}.
Published	12/13/2023	Dual antiplatelet therapy consists of {{c1::aspirin}} and {{c1::a P2Y12 inhibitor}} (e.g. clopidogrel)
Published	12/13/2023	Severely bradycardic patients resistant to atropine may require insertion of a {{c1::transvenous pacing wire}}.
Published	12/13/2023	Clopidogrel interferes with {{c1::platelet aggregation}} via inhibition of {{c3::ADP}} binding to {{c2::P2Y12}}.
Published	12/13/2023	Dabigatran and argatroban are both {{c1::direct thrombin inhibitors}}.
Published	12/13/2023	How much hydrocortisone is administered for adrenal suppression in minor surgeries?{{c1::25 mg IV}}
Published	12/13/2023	How much hydrocortisone is administered for adrenal suppression in moderate surgeries?{{c1::50 mg IV}}
Published	12/13/2023	How much hydrocortisone is administered for adrenal suppression in moderate surgeries?{{c1::100 mg IV}}
Published	12/13/2023	Valerian/Kava and St. John's Wort can prolong the duration of {{c2::anesthetic agents}}.
Published	12/13/2023	Ephedra has {{c1::sympathomimetic}} effects and interact with {{c2::MAOIs}} to cause serotonin syndrome
Published	12/13/2023	Should prophylactic antibiotics be administered to sterilize the sputum? {{c1::No}}
Published	12/13/2023	COPD causes vascular deficiencies in the lung periphery that appear as {{c1::emphysemic bullae}} and {{c2::pulmonary hyperlucency}} on CXR.
Published	12/13/2023	Characteristic signs of COPD on a CXR include {{c1::diaphragmatic flattening}} and {{c2::vertical}} orientation of the cardiac silhouette.
Published	12/13/2023	FEV1 / FVC ratio of less than 80% indicates {{c1::obstructive lung disease}}
Published	12/13/2023	Asthma differs from other COPDs in that it is {{c1::reversible}}
Published	12/13/2023	The hallmark of asthma is {{c1::airway inflammation}}
Published	12/13/2023	{{c1::Isoniazid}} and {{c1::Rifampin}} are antibiotics used to treat tuberculosis that have {{c2::hepato}}toxic effects
Published	12/13/2023	Diabetes insipidus causes {{c2::polyuria}} due to inadequate secretion of {{c1::antidiuretic hormone}}.
Published	12/13/2023	Blood urea nitrogen (BUN) does not accurately reflect GFR because {{c2::BUN}} is {{c1::reabsorbed}} in the tubules.
Published	12/13/2023	Patients with chronic kidney disease may be anemic due to enhanced fragility of RBCs in the presence of {{c1::uremia}}.
Published	12/13/2023	In diabetic patients, glycosylation of the joints causes {{c1::stiff joint}} syndrome.
Published	12/13/2023	In diabetic patients, a lack of respiratory variability in the heart rate reflects {{c1::autonomic neuropathy}}.
Published	12/13/2023	{{c3::Propylthiouracil::drug}} decreases the synthesis of {{c1::thyroxine (T4)}} and blocks its conversion to {{c2::T3}}.
Published	12/13/2023	A rare side effect of PTU therapy is {{c1::reversible agranulocytosis}}.
Published	12/13/2023	Hypothyroidism is diagnosed with decreased serum {{c1::T3/T4}}.
Published	12/13/2023	Hyperaldosternoism is a result of excess {{c1::mineralcorticoids}}.
Published	12/13/2023	The medications that most often cause PONV are {{c1::volatile anesthetics}}, {{c2::nitrous oxide}}, and {{c3::postoperative opioids}}.
Published	12/13/2023	What are the risk factors for postoperative vomiting (PONV) in children?History of {{c1::POV}}Surgery > {{c2::30}} minutesAge > {{c3::3}} years{…
Published	12/13/2023	Metabolic syndrome is comprised of these four risk factors:{{c1::Hypertension}}{{c3::Hyperglycemia}}{{c2::Dyslipidemia}}{{c4::Central obesity}}
Published	12/13/2023	What low-cost pharmacologic intervention helps prevent nosocomial pneumonia? {{c1::Pre-op oral antiseptic rinse}}
Published	12/13/2023	Type {{c2::2}} diabetics are susceptible to {{c1::hyperglycemic hyperosmolar state}}.
Published	12/13/2023	Fat depositions in Cushing's syndrome causes {{c1::moon}} facies, {{c2::buffalo}} humps, and {{c3::truncal}} obesity
Published	12/13/2023	Do steroids cause hyper- or hypo-glycemia?{{c1::Hyperglycemia}}
Published	12/13/2023	In patients with CNS tumors, {{c2::corticosteroids}} reduce {{c1::CSF production}} and {{c1::cerebral edema}}.
Published	12/13/2023	In patients with rheumatoid arthritis, {{c1::atlantoaxial::joint}} instability can limit head extension.
Published	12/13/2023	In patients with rheumatoid arthritis, {{c1::superior}} migration of the {{c1::odontoid}} can cause compression of the spinal cord.
Published	12/13/2023	Rheumatoid arthritis of the {{c1::temporomandibular}} joint may impede mouth opening for tracheal intubation.
Published	12/13/2023	{{c1::Proton pump inhibitors}} decrease gastric acid secretion by binding to the proton pumps of {{c2::parietal}} cells.
Published	12/13/2023	Midazolam and lorazepam are {{c1::more}} potent than diazepam because of {{c2::increased}} affinity for GABA receptors.
Published	12/13/2023	Pheochromocytoma presents with episodic {{c1::palpitations}}, headache, and diaphoresis.
Published	12/13/2023	Which thyroid imbalance presents with fine hair?{{c1::Hyperthyroidism}}
Published	12/13/2023	{{c1::Atropine}} is not commonly used as a antisialagogue because it may cause {{c2::tachycardia}}.
Published	12/13/2023	What type of surgeries place adults at risk for PONV?{{c1::Cholecystectomy}}, {{c1::laparoscopic}}, and {{c1::gynecologic}}
Published	12/13/2023	{{c1::General}} anesthesia is a risk factor for PONV.
Published	12/13/2023	What are the hematological effects of tobacco smoking?{{c1::Increased risk of clotting}}{{c2::Immunosuppression}} → leading to delayed wound healing
Published	12/13/2023	Signs of alcohol withdrawal include increased hand {{c1::tremors}}{{c2::autonomic}} hyperactivity{{c3::seizures}}
Published	12/13/2023	Increased ICP or cerebral ischemia can cause these effects in the eye:{{c1::papilledema}}{{c1::mydriasis}}
Published	12/13/2023	A GCS of {{c1::8}} is considered to comatose
Published	12/13/2023	{{c1::Electrocautery}} can accidentally activate an ICD's tachyarrhythmia detection.
Published	12/13/2023	Mobilization and clearance of pulmonary secretions can be enhanced with {{c1::chest physiotherapy}} and {{c2::hydration}}.
Published	12/13/2023	Chronic bronchitis manifests with a {{c1::low}} PaO2 and a {{c2::normal or high}} PaCO2 on ABG.
Published	12/13/2023	The best airway for children with upper respiratory tract infections is an {{c1::LMA}}.
Published	12/13/2023	The {{c1::Kupffer cells}} in the hepatic sinusoids filters and destroys {{c2::bacteria}}.
Published	12/13/2023	Autonomic neuropathy in patients with diabetes mellitus can manifest as {{c1::orthostatic hypotension::BP}} and {{c2::resting tachycardia::HR}}.
Published	12/13/2023	Adrenal insufficiency causes {{c1::hypo}}-tension.
Published	12/13/2023	Herbal medications:Licorice and goldenseal can cause {{c1::HTN}} and {{c1::edema}}
Published	12/13/2023	What diseases constitute the risk categories on the RCRI?{{c1::ischemic heart disease::CV}}{{c1::CHF::CV}}{{c1::CVA::neuro}}{{c1::DM::endocr…
Published	12/13/2023	What are fasting guidelines for clear liquids before elective surgeries in healthy patients?{{c1::2 hours}}
Published	12/13/2023	What are fasting guidelines for a light meal before elective surgeries in healthy patients?{{c1::6 hours}}
Published	12/13/2023	What are fasting guidelines for a full meal before elective surgeries in healthy patients?{{c1::>8 hours}}
Published	12/13/2023	What are fasting guidelines for breast milk/infant formula/nonhuman milk before elective surgeries in healthy patients?{{c1::4-6 hours}}
Published	12/13/2023	Pre-operative {{c2::anticholinergic}} medications can be given before airway procedures in order to {{c1::reduce secretions}}.
Published	12/13/2023	β-blockers should be {{c2::continued::held/continued}} the day of surgery.
Published	12/13/2023	Preoperative anemia can be treated with {{c1::iron}}, {{c1::folic acid}}, and {{c1::erythropoietin}}.
Published	12/13/2023	What herbal medications can cause hypoglycemia (2)?{{c1::Garlic and ginseng}}
Published	12/13/2023	{{c1::Hyper}}calcemia leads to muscle weakness.
Published	12/13/2023	Steroids predispose patients to {{c1::infections}}.
Published	12/13/2023	Do steroids cause hyper- or hypo-tension?{{c1::Hypertension}}
Published	12/13/2023	Do steroids cause fluid diuresis or retention?{{c1::Fluid retention}}
Published	12/13/2023	Rheumatoid arthritis of the {{c1::cricoarytenoid}} joint may decrease the glottic opening.
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