Surgical Decision Making in Patients with Heart Murmurs
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Questions and Answers

What is the purpose of assessing the patient's cardiovascular system preoperatively?

  • To check for respiratory rate and effort
  • To measure oxygen saturation at rest and exertion
  • To assess exercise tolerance (correct)
  • To evaluate sources of infection

What is the purpose of conducting a modified Mallampati test on the patient?

  • To predict difficulty in obtaining and securing the airway (correct)
  • To evaluate the patient's cognitive function
  • To assess abdominal masses and ascites
  • To check pulse rate and rhythm

When is a sickle cell test needed preoperatively?

  • In cases of suspicion of a sickle crisis or family history of sickle cell disease (correct)
  • In those with anaemia or ongoing blood loss
  • Not routinely offered
  • In patients over 65 years of age

Why are liver function tests indicated preoperatively?

<p>To check for jaundice and hepatitis (D)</p> Signup and view all the answers

When is an electrocardiogram (ECG) required preoperatively?

<p>For patients over 65 years of age (B)</p> Signup and view all the answers

What is the purpose of conducting an airway assessment preoperatively?

<p>To predict difficulty in obtaining and securing the airway (A)</p> Signup and view all the answers

When is a full blood count (FBC) needed preoperatively?

<p>Before all major operations (A)</p> Signup and view all the answers

What is an important step in the preoperative plan for the best patient outcomes?

<p>Anticipating and planning for adverse events (C)</p> Signup and view all the answers

Why is it important to gather and record all relevant information in the perioperative care?

<p>To optimize patient condition (C)</p> Signup and view all the answers

What information can be revealed by the history of past surgery and anaesthetic events?

<p>Problems that may be faced during future procedures (A)</p> Signup and view all the answers

Why should the use of recreational drugs and alcohol consumption be noted?

<p>To anticipate adverse outcomes (D)</p> Signup and view all the answers

What should be documented regarding a patient's drug history and allergies?

<p>Full drug history and list of allergies (A)</p> Signup and view all the answers

What does the preoperative plan advise regarding hydration, nutrition, and exercise?

<p>They are advised for adequate preparation (C)</p> Signup and view all the answers

What is an essential step in patient assessment during preoperative care?

<p>Conducting a thorough examination (B)</p> Signup and view all the answers

What is the purpose of β-Human chorionic gonadotrophin (pregnancy test) for women of childbearing age before surgery?

<p>To assess the need for obstetric advice during surgery (D)</p> Signup and view all the answers

What is the recommended action if a patient is found to be unfit based on Cardiopulmonary exercise testing (CPET)?

<p>Enroll in prehabilitation to improve fitness (C)</p> Signup and view all the answers

Which patient factor predisposes to a high risk of morbidity and mortality according to the text?

<p>Previous severe cardiorespiratory illness (A)</p> Signup and view all the answers

What is the purpose of Venous bicarbonate testing in the preoperative assessment?

<p>To give quick and vital information in acute or chronic severe respiratory conditions (B)</p> Signup and view all the answers

Why are βblockers and statins continued perioperatively for patients with Ischaemic Heart Disease?

<p>To maintain cardiac and coronary reserve (A)</p> Signup and view all the answers

What does a low-cost incremental shuttle walk test (ISWT) assess?

<p>Patient’s fitness for high-risk surgery (C)</p> Signup and view all the answers

What is the gold standard measurement of a patient’s fitness according to the text?

<p>(CPET) - Cardiopulmonary exercise testing (B)</p> Signup and view all the answers

According to the Royal College of Surgeons of England, what percentage of mortality risk requires active consultant input in all stages of patient management?

<p>5% (B)</p> Signup and view all the answers

What is the 30-day mortality percentage for a patient classified as American Society of Anesthesiologists (ASA) grade IV?

<p>18.3% (A)</p> Signup and view all the answers

What does the POSSUM score aim to predict?

<p>Mortality in postoperative critical care patients (B)</p> Signup and view all the answers

What does Lee’s Revised Cardiac Risk index stratify?

<p>Cardiac risk but not mortality (D)</p> Signup and view all the answers

What does the ACS NSQIP surgical risk score estimate?

<p>Chance of complications or death after surgery (D)</p> Signup and view all the answers

How should the urgency of surgery be graded for preoperative assessment?

<p>Immediate, urgent, expedited, elective (C)</p> Signup and view all the answers

What is the definition of day case surgery?

<p>Planned day admission followed by same-day discharge (C)</p> Signup and view all the answers

According to the day surgery selection criteria, what should be the patient's ability postoperatively?

<p>Ability to eat and drink or take oral nutrition (C)</p> Signup and view all the answers

What are the medical exclusions to day surgery according to the text?

<p>Patients with any poorly controlled abnormality/comorbidity (C)</p> Signup and view all the answers

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