Perioperative Glucocorticoid Coverage: Reassessment Quiz
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Questions and Answers

What endocrine metabolic reactions occur in response to surgical stress?

  • Norepinephrine and insulin secretion
  • Epinephrine and cortisol secretion (correct)
  • Insulin and cortisol secretion
  • Insulin and glucagon secretion

    • Why should elective surgery be avoided in patients with blood sugar levels greater than 200 mg/dl?

  • Reduced stress hormone release during surgery
  • Decreased risk of postoperative infection
  • Risk of hypoglycemia during surgery
  • Compromised healing due to inhibited insulin production (correct)

    • What is the recommended strategy for managing diabetes mellitus in preparation for surgery?

  • Avoid insulin injections on the day of surgery
  • Give half the insulin dose before surgery and the other half after surgery (correct)
  • Delay surgery until blood sugar levels normalize
  • Administer full insulin dose preoperatively

    • Why should joint surgery be avoided during flare-ups in arthritis patients?

    <p>Surgery may be less successful with active inflammation</p> Signup and view all the answers

    What type of patient should rheumatoid joint surgery be goal-oriented for?

    <p>Patients requiring correction of deformities</p> Signup and view all the answers

    Why is it important to assess for atlantoaxial subluxation in arthritis patients before surgery?

    <p>To identify potential risks during intubation</p> Signup and view all the answers

    What is the primary consideration for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT a common consideration for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>Assessing for subluxation</p> Signup and view all the answers

    What is the primary goal of preoperative management for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a key consideration for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    What is the primary reason for obtaining a thorough medical history and physical examination in patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT a common laboratory study performed preoperatively for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>Ankle-brachial index</p> Signup and view all the answers

    What is the primary goal of fluid replacement therapy for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a common consideration for patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    What is the primary reason for obtaining radiographic studies in patients with diabetes mellitus undergoing foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a common complication associated with diabetes mellitus that can impact foot and ankle surgery?

    <p>All of the above</p> Signup and view all the answers

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

    <p>Antimalarials, gold salts, penicillamine, and methotrexate</p> Signup and view all the answers

    What is the recommended prophylactic antibiotic for joint replacement surgery in patients with immunosuppression?

    <p>Cefazolin (Ancef) 1-2 gm IV 30 minutes before surgery</p> Signup and view all the answers

    What condition is present in 40% of rheumatoid arthritis patients?

    <p>Atlantoaxial subluxation</p> Signup and view all the answers

    What is the recommended treatment for preventing postoperative gout attacks in patients with gout?

    <p>Colchicine 0.6mg Bid for two days before surgery and one day postoperatively</p> Signup and view all the answers

    Which factor is NOT considered a risk factor for increased medical and surgical risk in patients with hypertension?

    <p>Well-controlled hypertension</p> Signup and view all the answers

    What is the recommended antibiotic prophylaxis for patients with rheumatic heart disease or mitral valve prolapse undergoing dental procedures?

    <p>Amoxicillin</p> Signup and view all the answers

    What is the recommended time frame to avoid elective surgery after a myocardial infarction (MI) in patients with ischemic heart disease?

    <p>6 months</p> Signup and view all the answers

    Which medication should be avoided in patients with hepatic disease due to its potential hepatotoxicity?

    <p>Halothane</p> Signup and view all the answers

    What is the recommended dose calculation for pediatric patients based on Clark's rule?

    <p>Weight/150 = fraction of adult dose</p> Signup and view all the answers

    Which statement is TRUE regarding geriatric patients undergoing surgery?

    <p>Their recovery time is often doubled compared to younger patients</p> Signup and view all the answers

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