Perioperative Glucocorticoid Coverage: A Reassessment

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What is the recommended perioperative hydrocortisone dosage for a patient undergoing minor surgery like hernia repair?

10-20 mg/day for 2-3 days

50-75 mg/day for 1-2 days

25 mg/day for 1 day (correct)

100-150 mg/day for 2-3 days

Why is it important to adjust antirheumatic drugs in the pre-operative period for patients with rheumatoid arthritis?

To ensure optimal pain relief and overall function improvement (correct)

To prevent hypotensive crisis

To avoid complications related to suppressed immune function

To minimize the risk of cardiovascular collapse

How long before surgery should NSAIDs be stopped according to the text?

24 hours

1 week

2 weeks

3-5 days (correct)

What is the main reason behind recommending a stress dose of corticosteroids for patients on long-term steroid therapy preoperatively?

To avoid hypotensive crisis and cardiovascular collapse Signup and view all the answers

What laboratory tests are advised in the preoperative period according to the text?

PT, PTT, bleeding time, serum transaminase, BUN, creatinine, uric acid Signup and view all the answers

What is the primary goal when considering surgery in a rheumatoid arthritis patient according to the text?

Pain relief and overall function improvement Signup and view all the answers

What is the minimal obligatory water intake or generation for a normal adult per day?

1600 mL Signup and view all the answers

Which of the following is NOT a source of obligatory water output in normal adults?

Saliva Signup and view all the answers

According to the "2/3, 1/3" rule for fluid distribution, what fraction of the total body water (TBW) is intracellular fluid?

2/3 Signup and view all the answers

For a 70 kg male, what is the approximate intravascular fluid volume?

5 L Signup and view all the answers

Which of the following intravenous fluids contains lactate?

Lactated Ringers Signup and view all the answers

What is the recommended preoperative management of glucocorticoid supplementation for patients on chronic corticosteroid therapy?

Hydrocortisone 100mg IV/IM the evening prior to surgery, another dose directly before surgery, and continued every 8 hours for the next day postoperatively. Signup and view all the answers

Which of the following statements regarding atlantoaxial subluxation in rheumatoid arthritis patients is correct?

Marked flexion of the neck can cause fracture or neurological interruption in patients with atlantoaxial subluxation. Signup and view all the answers

Which medication should be continued perioperatively to decrease the risk of arthritic flare-ups in patients with rheumatoid arthritis?

All of the above Signup and view all the answers

What is the recommended management of direct-acting oral anticoagulants (DOACs) for high bleeding risk procedures?

Stop DOACs 2 days before the procedure and resume 2 days after. Signup and view all the answers

Which of the following statements regarding the management of gout in the perioperative period is correct?

Both a and b are correct. Signup and view all the answers

Which of the following scenarios requires antibiotic prophylaxis for bacterial endocarditis in patients with rheumatic heart disease or mitral valve prolapse?

In-office procedures with amoxicillin prophylaxis Signup and view all the answers

Which of the following statements regarding the management of hypertension in the perioperative period is correct?

Mild hypertension will often resolve with induction of anesthesia and administration of pain medication. Signup and view all the answers

Which of the following statements regarding ischemic heart disease in the perioperative period is correct?

Both a and b are correct. Signup and view all the answers

Which of the following statements regarding pediatric patients in the perioperative period is correct?

General anesthesia is favored, and measures should be taken to prevent hypothermia due to poor thermoregulation. Signup and view all the answers

Which of the following statements regarding geriatric patients in the perioperative period is correct?

Multiple medications and potential drug interactions should be considered. Signup and view all the answers