ABCS ABCS Anesthesia and Perioperative Care 2 — Questions and Answers
Question 1: Which class of medications should typically be held before elective cosmetic surgery due to increased bleeding risk?
- Anticoagulants and NSAIDs (Correct answer)
- Antihypertensives
- Proton pump inhibitors
- Thyroid hormone replacements
Correct answer: Anticoagulants and NSAIDs
Anticoagulants and NSAIDs inhibit platelet function or clotting cascades and must generally be stopped before elective procedures to minimize intraoperative bleeding.
Question 2: What is the purpose of a 'time-out' procedure immediately before beginning a cosmetic surgery in the US?
- To verify patient identity, procedure, and site to prevent wrong-site surgery (Correct answer)
- To allow the surgeon to rest before a long case
- To confirm anesthesia billing codes
- To review postoperative care instructions with the patient
Correct answer: To verify patient identity, procedure, and site to prevent wrong-site surgery
A surgical time-out is a standardized safety pause where the entire team confirms the correct patient, procedure, and surgical site before the first incision.
Question 3: A cosmetic surgery patient develops laryngospasm during emergence from general anesthesia. What is the immediate intervention?
- Apply positive pressure ventilation with 100% oxygen (Correct answer)
- Administer oral antihistamines
- Place the patient in Trendelenburg position only
- Perform a chest X-ray immediately
Correct answer: Apply positive pressure ventilation with 100% oxygen
Laryngospasm is managed immediately with positive-pressure oxygen ventilation, and succinylcholine may be given if it does not resolve, to break the spasm and restore the airway.
Question 4: Which type of anesthesia is most appropriate for an abdominoplasty (tummy tuck) performed in a US accredited outpatient surgical facility?
- General anesthesia or deep sedation with local anesthesia (Correct answer)
- Topical anesthesia alone
- Spinal anesthesia alone without sedation
- No anesthesia with distraction therapy
Correct answer: General anesthesia or deep sedation with local anesthesia
Abdominoplasty requires adequate muscle relaxation and pain control, making general anesthesia or deep sedation combined with local infiltration the standard approach.
Question 5: What is the significance of the Mallampati classification in preoperative anesthesia assessment for cosmetic surgery?
- It predicts difficulty of endotracheal intubation based on oral cavity visibility (Correct answer)
- It measures the patient's BMI
- It grades the severity of skin laxity
- It classifies the type of cosmetic implant needed
Correct answer: It predicts difficulty of endotracheal intubation based on oral cavity visibility
The Mallampati score classifies the visibility of oral structures to estimate potential difficulty in securing the airway during intubation.
Question 6: Post-surgery nausea and vomiting (PONV) is especially concerning after cosmetic procedures because it can:
- Increase tension on wound closures and raise hematoma risk (Correct answer)
- Improve lymphatic drainage
- Accelerate tissue healing
- Reduce swelling and bruising
Correct answer: Increase tension on wound closures and raise hematoma risk
Straining from vomiting raises venous pressure, which can disrupt suture lines and lead to hematoma formation, a serious complication in cosmetic surgery.
ABCS ABCS Anesthesia and Perioperative Care 2
Which class of medications should typically be held before elective cosmetic surgery due to increased bleeding risk?