Peri-operative surgery

Question 1

Muscle relaxants (x4)

Answer 1

Suxamethonium
Atracurium
Vecurinium
Pancuronium

Question 2

ASA I

Answer 2

Healthy non-smoking and minimal alcohol

Question 3

ASA II

Answer 3

Patient with mild systemic disease without substantive functional limitations eg: smoking, pregnancy, obesity, well controlled DM/HTN

Question 4

ASA III

Answer 4

Patient with a severe systemic disease - poorly controlled DM/HTN, COPD, morbid obesity (>40), active hepatitis, moderate reduction in EF, ESRD, CVAs

Question 5

ASA IV

Answer 5

Patient with severe systemic disease that is constant threat to life. <3 month MI hx, severe valve disease, sepsis, DIC, ARDs or ESRD wo dialysis

Question 6

ASA V

Answer 6

Moribund patient who is not expected to survive without operation eg ruptured AAA, trauma, intracranial bleed with mass effect

Question 7

ASA VI

Answer 7

Declared brain dead whose organs are being removed for donor purposes

Question 8

Maintenance fluid rate

Answer 8

30 ml/kg/24hr

Question 9

Absorbable surtures

Answer 9

Vicryl
Dexon
PDS

Question 10

Non-absorbable sutures

Answer 10

Silk
Novafil
Prolene
Ethilon

Question 11

Local anaesthetic

Answer 11

Lidocaine:

• Rapid onset, lasts 1 hr
• Max safe dose 3mg/kg
• Adrenaline increases duration of action. (don’t use at extremities)

Question 12

Ovarian Ca marker

Answer 12

CA 125

Question 13

Pancreatic cancer marker

Answer 13

CA 19-9

Question 14

Breast cancer marker

Answer 14

CA 15-3

Question 15

Prostate cancer marker

Answer 15

PSA

Question 16

Hepatocellular cancer and teratoma marker

Answer 16

Alpha-feto protein (AFP)

Question 17

Colorectal cancer marker

Answer 17

Carcinoembryonic antigen (CEA)

Question 18

Melanoma and schwannomas marker

Answer 18

S-100

Question 19

Cancer marker for Small cell lung cancer, gastric cancer, neuroblastoma

Answer 19

Bombesin

Question 20

Indications for packed red cells

Answer 20

• transfusion of chronic anaemia

- large volume blood loss

Question 21

Platelet rich plasma

Answer 21

administered to patients who are thrombocytopaemic and are bleeding or require surgery

Question 22

Platelet rich concentrate

Answer 22

Given to patients with thrombocytopaenia

Question 23

FFP

Answer 23

• prepared from units of blood
• clotting factors, albumin and immunoglobulin
• Used to correct clotting deficiencies in patients with hepatic synthetic failure

Question 24

Cryoprecipitate

Answer 24

• formed from supernatant of FFP

- Rich in Factor VIII and fibrinogen

Question 25

SAG-Mannitol blood

Answer 25

Removal of all plasma from blood and substituted with:

• NaCl
• Adenine
• Anhydrous glucose
• mannitol