THIS IS A GROUP ACTIVITY: Medical Evaluation of the Surgical Adult Patient: Quiz

Question 1:

A 65-year-old male patient is scheduled for elective cholecystectomy. He has a history of hypertension, coronary artery disease (CAD), and type 2 diabetes mellitus. Which of the following laboratory tests would be most appropriate to evaluate his baseline surgical risk?

A) Coagulation profile
B) Complete blood count (CBC)
C) Arterial blood gas (ABG)
D) Liver function tests (LFTs)

Question 2:

During the preoperative assessment, a 55-year-old woman presents with a history of asthma, including a recent exacerbation requiring prednisone therapy. What is the most important consideration in managing her perioperative care?

A) Increased risk of wound infection
B) Potential for postoperative respiratory distress due to asthma
C) Increased risk of deep vein thrombosis (DVT)
D) Need for increased hydration and electrolytes

Question 3:

Which of the following physical examination findings would be most concerning in a patient undergoing elective surgery?

A) Jugular venous distention with bilateral pitting edema
B) A systolic ejection murmur at the left sternal border
C) Unilateral lower extremity swelling without redness
D) Decreased breath sounds in the lower lung fields

Question 4:

A 45-year-old woman is undergoing surgery for a large ovarian cyst. Her preoperative ECG shows left ventricular hypertrophy (LVH). Which of the following tests would be most appropriate to assess her cardiac risk?

A) Cardiac stress test
B) Chest X-ray
C) Echocardiogram
D) Serum troponin levels

Question 5:

Which of the following findings on history is most likely to increase a patient's perioperative risk, particularly for anesthetic complications?

A) History of uncomplicated gallstone disease
B) History of malignant hyperthermia in a close family member
C) Hypertension well controlled with medication
D) Routine use of over-the-counter ibuprofen for mild pain

Question 6:

A 72-year-old male with a history of congestive heart failure (CHF) is scheduled for a hip replacement. Which of the following preoperative interventions would most likely help reduce his surgical risk?

A) Administration of prophylactic antibiotics
B) Optimization of heart failure management with diuretics
C) Use of compression stockings to prevent venous thromboembolism (VTE)
D) Discontinuation of all antihypertensive medications

Question 7:

During the preoperative assessment, a 68-year-old diabetic patient undergoing surgery for bowel obstruction is noted to have an HbA1c level of 9.5%. What is the most appropriate action to optimize this patient's perioperative care?

A) Increase the dose of insulin for 1-2 days before surgery
B) Cancel surgery until glycemic control improves
C) Switch to insulin infusion therapy intraoperatively
D) Decrease oral hypoglycemics 24 hours before surgery and monitor blood glucose

Question 8:

A 60-year-old male patient presents for elective hernia repair. He reports no significant medical history, but his family history includes a brother who developed deep vein thrombosis (DVT) at age 45. Which of the following would be most appropriate to assess his risk for perioperative thromboembolic events?

A) Screening for factor V Leiden mutation
B) Routine D-dimer testing
C) Preoperative echocardiogram
D) Lower extremity ultrasound for deep vein thrombosis

Question 9:

A patient with a history of chronic obstructive pulmonary disease (COPD) is scheduled for abdominal surgery. Which of the following is the most appropriate preoperative test to assess his pulmonary function?

A) Chest X-ray
B) Preoperative spirometry
C) Arterial blood gas (ABG) analysis
D) Electrocardiogram (ECG)

Question 10:

A 60-year-old woman with a history of well-controlled hypertension and no other comorbidities is undergoing a routine cataract surgery. Which of the following is most important to evaluate during the preoperative medical assessment?

A) Electrocardiogram (ECG)
B) Arterial blood gas (ABG)
C) Coagulation profile
D) Chest X-ray