General Surgery Board Review General Surgery Board Review Perioperative Care & Complications 1

Question 1

Which ASA physical status classification is assigned to a patient with severe systemic disease that is a constant threat to life?

Accepted Answer

ASA IV

Answer

ASA IV denotes a patient with a severe systemic disease that is a constant threat to life, such as recent MI, CVA, TIA, or ongoing cardiac ischemia.

Question 2

A patient on warfarin for atrial fibrillation requires elective colon resection. What is the standard perioperative anticoagulation strategy for high-thromboembolic-risk patients?

Accepted Answer

Stop warfarin 5 days before and bridge with therapeutic heparin

Answer

High-risk patients (e.g., mechanical mitral valve, high-risk AF) should stop warfarin 5 days preoperatively and receive bridging therapy with LMWH or UFH until surgery.

Question 3

Per ASA guidelines, what is the minimum fasting time for clear liquids before elective surgery in healthy adults?

Accepted Answer

2 hours

Answer

The ASA recommends a minimum 2-hour fast for clear liquids (including water, clear juices, carbonated beverages, and black coffee) before elective procedures.

Question 4

Antibiotic prophylaxis for colorectal surgery should target which organisms?

Accepted Answer

Both gram-negative aerobes and anaerobes

Answer

Colorectal surgery prophylaxis must cover both gram-negative aerobes and anaerobes (e.g., cefazolin + metronidazole, or cefoxitin alone) due to the mixed flora of the colon.

Question 5

Surgical antibiotic prophylaxis with cefazolin should be administered at what time relative to skin incision for optimal tissue levels?

Accepted Answer

Within 60 minutes before incision

Answer

Cefazolin should be administered within 60 minutes before skin incision (30–60 minutes recommended) to ensure adequate tissue concentrations at the time of incision.

General Surgery Board Review Practice Test

General Surgery Board Review Practice Test

General Surgery Board Review General Surgery Board Review Perioperative Care & Complications 1