History Taking and risk assessment

Question 0

How do you calculate BMI?

Answer 0

BMI= kg/m^2

Question 1

When interviewing a patient with a language barrier, is it appropriate to use family members to translate?

Answer 1

No. Use hospital approved outside translators for consents and interviews

Question 2

What BMI is considered normal?

Answer 2

18.5-24.9

Question 3

What BMI is considered obese?

Answer 3

Anything greater than 30

Question 4

Why is it important to chart if a patient is hoarse?

Answer 4

Because hoarseness may be due to vocal cord damage and you don’t want to be blamed for damaging their vocal cords if they already came to you that way.

Question 5

What is the approximate number and Americans have CAD

Answer 5

~10,000,000

Question 6

About how many Americans with significant CAD will undergo anesthesia/surgery for non-cardiac operations?

Answer 6

750,000

Question 7

What is the mortality rate of intraoperative MI?

Answer 7

38-70%

Question 8

Who receives CHEM 7 pre-op?

Answer 8

All patients over 60
All ESRD patients
Pre and post-op blood sugar for all DM patients

Question 9

Who gets Hgb and Hct pre-op?

Answer 9

All menstruating women
All patients over 60
High likelihood of significant blood loss during surgery

Question 10

Who gets CXR pre-op?

Answer 10

All patients over 60
All patients with TB
All patients with spontaneous PTX

Question 11

Who gets EKG pre-op?

Answer 11

All patients over 50

All patients with past MI, CABG, or arrhythmias

Question 12

Who gets HCG pre-op?

Answer 12

All women of menstruating age

Question 13

Who gets coagulation studies pre-op?

Answer 13

All patients on anticoagulant therapy

All patients considering regional anesthesia

Question 14

What is a normal FEV1/FVC ratio?

Answer 14

80%

Question 15

Volume of gas exhales in one second by forced expiration from full inspiration is called?

Answer 15

FEV1

Question 16

What is vital capacity?

Answer 16

The total volume of has exhaled from slow, complete expiration after maximal inspiration.

Question 17

ASA Classification

Class I

Answer 17

No health problems and under the age of 80

Question 18

ASA Classification

Class II

Answer 18

Mild systemic disease

Examples: controlled HTN, mild asthma, smoking, controlled DM, obesity

Question 19

ASA Classification

Class III

Answer 19

Severe, not incapacitating systemic disease

Examples: uncontrolled HTN, prior MI, ESRD, COPD, angina pectoris

Question 20

ASA Classification

Class IV

Answer 20

Incapacitating disease that is a constant threat to life

Examples: active CAD with angina, severe valvular stenosis/regurgitation, cerebral aneurysm, AAA, ESRD with multiple systems involved

Question 21

ASA Classification

Class V

Answer 21

Moribund patient, not expected to survive 24 hours regardless of surgery

Examples: severe trauma, ruptured cerebral, septic shock, uterine rupture, aortic dissection

Question 22

ASA Classification

E

Answer 22

Suffix added to any of the ASA classes to denote an emergency situation

Examples: crash c/s, open fracture, ruptured AAA, CHI w/decompensation, NPO status waived for passage through OR

Question 23

ASA Classification 48 hr mortality

Class I

Answer 23

0.07%

Question 24

ASA Classification 48 hr mortality | Class II

Answer 24

0.24%

Question 25

ASA Classification 48 hr mortality | Class III

Answer 25

1.4%

Question 26

ASA Classification 48 hr mortality | Class IV

Answer 26

7.5%

Question 27

ASA Classification 48 hr mortality | Class V

Answer 27

8.1%

Question 28

ASA Classification 48 hr mortality | Class E

Answer 28

Doubles the risk

Question 29

ASA Classification | Class VI

Answer 29

Brain dead patient for organ harvest