Preoperative Evaluation & Risk Assessment Flashcards
7 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Preoperative Evaluation & Risk Assessment flashcards as text
A 68-year-old patient with severe aortic stenosis (valve area 0.6 cm²) requires emergency hip fracture repair. Which anesthetic consideration is most important?
Answer: Avoid tachycardia and maintain sinus rhythm
Severe aortic stenosis requires maintaining sinus rhythm and avoiding tachycardia to preserve adequate diastolic filling and cardiac output.
The Revised Cardiac Risk Index (RCRI) assigns one point each for which of the following conditions?
Answer: High-risk surgery, ischemic heart disease, CHF, cerebrovascular disease, diabetes on insulin, creatinine >2.0 mg/dL
The RCRI includes six factors: high-risk surgery, ischemic heart disease, CHF, cerebrovascular disease, insulin-dependent diabetes, and creatinine >2.0 mg/dL.
A patient is scheduled for elective total knee replacement. Preoperative ECG shows new left bundle branch block (LBBB) not present on prior ECG. What is the most appropriate next step?
Answer: Postpone surgery and refer for cardiology evaluation
New LBBB may indicate acute myocardial ischemia or significant structural heart disease and warrants cardiology evaluation before elective surgery.
Which pulmonary function test result most strongly predicts postoperative pulmonary complications after pneumonectomy?
Answer: Predicted postoperative FEV1 <40% of predicted
Predicted postoperative FEV1 (ppo-FEV1) <40% of predicted is the most established threshold associated with significantly increased postoperative pulmonary complications after lung resection.
A patient taking clopidogrel for a drug-eluting coronary stent placed 8 months ago requires urgent colectomy for bowel obstruction. What is the best management strategy?
Answer: Continue clopidogrel perioperatively and use surgical hemostatic techniques
For urgent surgery within 12 months of drug-eluting stent placement, continuing antiplatelet therapy is preferred to prevent in-stent thrombosis, with surgical hemostasis techniques employed.
Which preoperative factor is most predictive of difficult mask ventilation?
Answer: BMI >26, age >55, history of snoring, no teeth, presence of beard
The MOANS mnemonic (Mask seal difficulty, Obesity/Obstruction, Age >55, No teeth, Stiff lungs/Snoring) identifies predictors of difficult mask ventilation.
A 55-year-old woman with systemic lupus erythematosus presents for elective hysterectomy. She takes prednisone 10 mg daily. Which perioperative steroid management is most appropriate?
Answer: Continue home dose and give hydrocortisone 50 mg IV at induction, then 25 mg q8h for 24 hours
Patients on chronic steroids require stress-dose supplementation for major surgery; hydrocortisone 50 mg at induction followed by 25 mg q8h for 24 hours covers HPA axis suppression.