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 patient with type 1 diabetes presents for elective laparoscopic surgery. Preoperative glucose is 285 mg/dL. What is the most appropriate action before proceeding?
Answer: Administer insulin to achieve a glucose of 140–180 mg/dL, then proceed when controlled
Perioperative hyperglycemia above 250 mg/dL increases infection risk and metabolic instability; correcting to 140–180 mg/dL before proceeding is the accepted standard.
During preoperative evaluation, a patient mentions he has been taking St. John's Wort for 6 months. Which anesthetic interaction is most clinically relevant?
Answer: Induction of CYP enzymes leading to decreased efficacy of opioids, benzodiazepines, and cyclosporine
St. John's Wort is a potent CYP3A4 and P-glycoprotein inducer, reducing plasma levels of numerous drugs including opioids, benzodiazepines, and immunosuppressants.
A 30-year-old woman with a history of pseudocholinesterase deficiency is scheduled for laparoscopic surgery. Which preoperative consideration is most important?
Answer: Avoid succinylcholine and ensure adequate reversal monitoring if mivacurium is considered
Pseudocholinesterase deficiency prolongs the action of succinylcholine (and mivacurium) by impairing hydrolysis; these agents should be avoided or used with prolonged neuromuscular monitoring.
Which preoperative test is most useful for quantifying functional capacity when a patient cannot exercise adequately due to orthopedic limitations?
Answer: Dobutamine stress echocardiography
Dobutamine stress echocardiography provides pharmacologic stress assessment of cardiac function when patients cannot perform adequate physical exercise.
A patient with a documented latex allergy presents for elective surgery. Which preoperative measure is most essential?
Answer: Schedule the patient as the first case of the day in a latex-free environment
Scheduling a latex-allergic patient as the first case minimizes aerosolized latex contamination from previous cases, and all equipment must be latex-free.
When evaluating a patient with suspected difficult airway, which combination of findings most strongly supports planning for awake intubation?
Answer: Mallampati class IV, limited neck extension, history of failed intubation
Multiple converging predictors—Mallampati IV, limited neck extension, and prior documented failed intubation—represent the highest-risk profile and mandate an awake airway technique.
A patient on long-term corticosteroids (prednisone 15 mg/day for 2 years) is scheduled for major abdominal surgery. Which perioperative management is most appropriate?
Answer: Administer stress-dose corticosteroids (hydrocortisone 50–100 mg IV) perioperatively to prevent adrenal insufficiency
Long-term supraphysiologic steroid use suppresses the HPA axis; major surgery constitutes a significant stressor requiring perioperative stress-dose hydrocortisone to prevent adrenal crisis.