Patient Assessment and Evaluation Flashcards
7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Assessment and Evaluation flashcards as text
A 72-year-old patient with a history of transient ischemic attacks is on warfarin (INR 2.4) and requires urgent appendectomy. What is the most appropriate reversal strategy?
Answer: 4-factor prothrombin complex concentrate plus vitamin K
4-factor PCC provides rapid reversal of warfarin within minutes, supplemented by IV vitamin K for sustained effect, making it the preferred approach for urgent surgery.
Which feature of the preoperative history is most predictive of a difficult laryngoscopy independent of Mallampati score?
Answer: History of prior difficult intubation
A documented history of prior difficult laryngoscopy or intubation is the single most predictive factor for a subsequent difficult airway.
A patient with a pacemaker is scheduled for electrosurgery in the abdominal region. Which preoperative action is essential?
Answer: Determine the pacemaker type, programming, and pacemaker dependence, and arrange for reprogramming or magnet availability
Knowing whether the patient is pacemaker-dependent and the device's response to electromagnetic interference guides the decision to reprogram or use a magnet intraoperatively.
During a preoperative visit, a patient scheduled for abdominal surgery is noted to have a serum sodium of 124 mEq/L. The surgery is elective. What is the most appropriate decision?
Answer: Postpone surgery and correct hyponatremia to above 130 mEq/L before proceeding
Severe hyponatremia (Na < 130 mEq/L) increases the risk of cerebral edema and seizures; elective surgery should be deferred until the sodium is safely corrected.
A patient with COPD and FEV1/FVC of 0.52 presents for elective inguinal hernia repair under neuraxial anesthesia. Which preoperative optimization step is most important?
Answer: Ensure bronchodilator therapy is optimized and the patient is at baseline pulmonary function
Optimizing bronchodilator therapy and ensuring the patient is at their best baseline pulmonary status reduces perioperative bronchospasm and respiratory complications.
Which preoperative finding in a patient with liver cirrhosis most accurately predicts postoperative mortality risk?
Answer: MELD score greater than 15
The MELD score is the most validated predictor of 30-day and 90-day postoperative mortality in cirrhotic patients undergoing surgery.
A 45-year-old woman scheduled for laparoscopic hysterectomy reports a family history of malignant hyperthermia in a sibling. She has never had general anesthesia. What is the most appropriate preoperative recommendation?
Answer: Plan a trigger-free anesthetic with non-triggering agents and have dantrolene available
A first-degree family history of MH mandates treating the patient as MH-susceptible; a trigger-free anesthetic and readily available dantrolene are the standard of care.