ABPS Preoperative Assessment & Postoperative Care 3 — Questions and Answers
Question 1: When counseling a patient preoperatively for breast reduction, which symptom assessment is most important for insurance authorization?
- Breast ptosis grade
- Neck and back pain documentation (Correct answer)
- Cup size relative to height
- Patient-reported aesthetic dissatisfaction
Correct answer: Neck and back pain documentation
Documentation of symptomatic neck and back pain, along with conservative treatment failures, is typically required by insurers for coverage of reduction mammaplasty.
Question 2: What is the primary purpose of a preoperative marking session in rhinoplasty?
- Documenting the patient's consent
- Identifying anatomical landmarks and planning the surgical approach (Correct answer)
- Testing anesthetic sensitivity
- Measuring nasal airflow
Correct answer: Identifying anatomical landmarks and planning the surgical approach
Preoperative markings define anatomical landmarks, plan osteotomy sites, and guide the surgical technique specific to each patient's nasal anatomy.
Question 3: A patient on chronic SSRI therapy undergoes elective rhinoplasty. The most important perioperative concern related to SSRIs is:
- Increased risk of malignant hyperthermia
- Impaired platelet aggregation and increased bleeding risk (Correct answer)
- Risk of serotonin-induced hypertension
- Interaction with local anesthetics
Correct answer: Impaired platelet aggregation and increased bleeding risk
SSRIs inhibit serotonin reuptake in platelets, reducing platelet aggregation and increasing intraoperative and postoperative bleeding risk.
Question 4: Which patient characteristic most strongly predicts poor wound healing following plastic surgery?
- Age over 50
- Active tobacco smoking (Correct answer)
- BMI of 26
- Female sex
Correct answer: Active tobacco smoking
Active smoking causes vasoconstriction and tissue hypoxia, significantly impairing wound healing and increasing risk of flap necrosis and dehiscence.
Question 5: Postoperative fever on day 1 after a major plastic surgery procedure is most likely caused by:
- Surgical site infection
- Atelectasis (Correct answer)
- Deep vein thrombosis
- Drug hypersensitivity
Correct answer: Atelectasis
Atelectasis is the most common cause of fever in the first 24–48 hours postoperatively due to shallow breathing and mucus plugging after general anesthesia.
Question 6: A patient develops a seroma 2 weeks after abdominoplasty. What is the first-line management?
- Immediate surgical drainage under general anesthesia
- Observation with compression garment only
- Aspiration under sterile technique (Correct answer)
- Oral antibiotics and heat therapy
Correct answer: Aspiration under sterile technique
Aspiration under sterile technique is the first-line management for postoperative seroma, providing immediate relief and diagnostic fluid sampling.
Question 7: Which preoperative finding would prompt postponement of an elective liposuction procedure?
- Controlled type 2 diabetes with HbA1c of 7.2%
- Blood pressure of 165/105 mmHg on arrival (Correct answer)
- History of penicillin allergy
- Platelet count of 180,000/μL
Correct answer: Blood pressure of 165/105 mmHg on arrival
Uncontrolled hypertension (BP >160/100 mmHg) warrants postponement of elective surgery due to elevated risk of intraoperative cardiovascular events and bleeding.
ABPS Preoperative Assessment & Postoperative Care 3
When counseling a patient preoperatively for breast reduction, which symptom assessment is most important for insurance authorization?