Surgical Decision Making in Patients with Heart Murmurs

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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?

To check for jaundice and hepatitis Signup and view all the answers

When is an electrocardiogram (ECG) required preoperatively?

For patients over 65 years of age Signup and view all the answers

What is the purpose of conducting an airway assessment preoperatively?

To predict difficulty in obtaining and securing the airway Signup and view all the answers

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

Before all major operations Signup and view all the answers

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

Anticipating and planning for adverse events Signup and view all the answers

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

To optimize patient condition Signup and view all the answers

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

Problems that may be faced during future procedures Signup and view all the answers

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

To anticipate adverse outcomes Signup and view all the answers

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

Full drug history and list of allergies Signup and view all the answers

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

They are advised for adequate preparation Signup and view all the answers

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

Conducting a thorough examination Signup and view all the answers

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

To assess the need for obstetric advice during surgery 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)?

Enroll in prehabilitation to improve fitness Signup and view all the answers

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

Previous severe cardiorespiratory illness Signup and view all the answers

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

To give quick and vital information in acute or chronic severe respiratory conditions Signup and view all the answers

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

To maintain cardiac and coronary reserve Signup and view all the answers

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

Patient’s fitness for high-risk surgery Signup and view all the answers

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

(CPET) - Cardiopulmonary exercise testing 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?

5% 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?

18.3% Signup and view all the answers

What does the POSSUM score aim to predict?

Mortality in postoperative critical care patients Signup and view all the answers

What does Lee’s Revised Cardiac Risk index stratify?

Cardiac risk but not mortality Signup and view all the answers

What does the ACS NSQIP surgical risk score estimate?

Chance of complications or death after surgery Signup and view all the answers

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

Immediate, urgent, expedited, elective Signup and view all the answers

What is the definition of day case surgery?

Planned day admission followed by same-day discharge Signup and view all the answers

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

Ability to eat and drink or take oral nutrition Signup and view all the answers

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

Patients with any poorly controlled abnormality/comorbidity Signup and view all the answers