26 Questions
What endocrine metabolic reactions occur in response to surgical stress?
Epinephrine and cortisol secretion
Why should elective surgery be avoided in patients with blood sugar levels greater than 200 mg/dl?
Compromised healing due to inhibited insulin production
What is the recommended strategy for managing diabetes mellitus in preparation for surgery?
Give half the insulin dose before surgery and the other half after surgery
Why should joint surgery be avoided during flare-ups in arthritis patients?
Surgery may be less successful with active inflammation
What type of patient should rheumatoid joint surgery be goal-oriented for?
Patients requiring correction of deformities
Why is it important to assess for atlantoaxial subluxation in arthritis patients before surgery?
To identify potential risks during intubation
What is the primary consideration for patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
Which of the following is NOT a common consideration for patients with diabetes mellitus undergoing foot and ankle surgery?
Assessing for subluxation
What is the primary goal of preoperative management for patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
Which of the following is a key consideration for patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
What is the primary reason for obtaining a thorough medical history and physical examination in patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
Which of the following is NOT a common laboratory study performed preoperatively for patients with diabetes mellitus undergoing foot and ankle surgery?
Ankle-brachial index
What is the primary goal of fluid replacement therapy for patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
Which of the following is a common consideration for patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
What is the primary reason for obtaining radiographic studies in patients with diabetes mellitus undergoing foot and ankle surgery?
All of the above
Which of the following is a common complication associated with diabetes mellitus that can impact foot and ankle surgery?
All of the above
Which medication should be continued in patients with rheumatoid arthritis to decrease arthritic flare-ups?
Antimalarials, gold salts, penicillamine, and methotrexate
What is the recommended prophylactic antibiotic for joint replacement surgery in patients with immunosuppression?
Cefazolin (Ancef) 1-2 gm IV 30 minutes before surgery
What condition is present in 40% of rheumatoid arthritis patients?
Atlantoaxial subluxation
What is the recommended treatment for preventing postoperative gout attacks in patients with gout?
Colchicine 0.6mg Bid for two days before surgery and one day postoperatively
Which factor is NOT considered a risk factor for increased medical and surgical risk in patients with hypertension?
Well-controlled hypertension
What is the recommended antibiotic prophylaxis for patients with rheumatic heart disease or mitral valve prolapse undergoing dental procedures?
Amoxicillin
What is the recommended time frame to avoid elective surgery after a myocardial infarction (MI) in patients with ischemic heart disease?
6 months
Which medication should be avoided in patients with hepatic disease due to its potential hepatotoxicity?
Halothane
What is the recommended dose calculation for pediatric patients based on Clark's rule?
Weight/150 = fraction of adult dose
Which statement is TRUE regarding geriatric patients undergoing surgery?
Their recovery time is often doubled compared to younger patients
Test your knowledge on perioperative glucocorticoid coverage based on a study published in the Annals of Surgery in 1994. Questions cover the use of corticosteroid supplementation, immunosuppressive drugs, prophylactic antibiotics, and related topics.
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