ABA Patient Assessment and Evaluation 3

Question 1

A patient with end-stage renal disease on hemodialysis presents for arteriovenous fistula revision. Which preoperative concern is most specific to this patient population?

Accepted Answer

Hyperkalemia-induced cardiac dysrhythmias

Answer

Patients on hemodialysis are prone to hyperkalemia, which can cause life-threatening dysrhythmias; a preoperative potassium level and recent dialysis timing must be confirmed.

Question 2

Which of the following best describes the significance of a STOP-BANG score of 5 or greater in a preoperative patient?

Accepted Answer

High risk for obstructive sleep apnea requiring perioperative precautions

Answer

A STOP-BANG score ≥ 5 indicates high risk for moderate-to-severe OSA, warranting perioperative precautions such as continuous pulse oximetry and possible CPAP use.

Question 3

A 55-year-old patient reports a prior episode of 'awareness during surgery' years ago. Which preoperative action is most important when planning the current anesthetic?

Accepted Answer

Document the history, assess for contributing factors, and discuss the anesthetic plan and monitoring with the patient

Answer

Thorough documentation and counseling are essential; identifying prior risk factors (light anesthesia, paralysis without adequate hypnosis) guides the individualized anesthetic plan.

Question 4

Which preoperative cardiac evaluation is indicated in a patient with poor functional capacity (< 4 METs) scheduled for high-risk vascular surgery who has two clinical risk factors per the Revised Cardiac Risk Index?

Accepted Answer

Pharmacologic stress testing

Answer

Per ACC/AHA guidelines, patients with poor functional capacity, elevated surgical risk, and clinical risk factors may benefit from pharmacologic stress testing to guide further management.

Question 5

During preoperative evaluation, a patient with rheumatoid arthritis taking methotrexate presents for elective shoulder surgery. Which airway concern is most critical for this population?

Accepted Answer

Atlantoaxial instability causing risk of cervical cord injury during intubation

Answer

Rheumatoid arthritis can cause atlantoaxial subluxation, which poses a risk of cervical spinal cord injury during neck manipulation for intubation.

(ABA) American Board of Anesthesiology Practice Test

(ABA) American Board of Anesthesiology Practice Test

ABA Patient Assessment and Evaluation 3