Patient evaluation, informed consent, preoperative assessment and care Flashcards Preview

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Flashcards in Patient evaluation, informed consent, preoperative assessment and care Deck (28)
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1
Q

Patients who have had organ transplants should have Abx prophylaxis with cefalexin 1g, dicloxacillin 1g or azithromycin 500mg orally just before the procedure

A

F
1 hour before
if their physician has advised it

2
Q

Vitamin E (alpha-tocopherol) is a potential anticoagulant.

A

T

3
Q

The combination of non selective beta blockers (such as propranolol) and adrenaline may result in malignant hypertension, reflex bradycardia and even death

A

T

Selective beta blockers are ok

4
Q

Patients with surgically repaired atrial or ventral septal defects are high-risk for developing bacterial endocarditis following a surgical procedure.

A

F
Low-risk
High-risk are pts with prosthetic valves, previous endocarditis, complex congenital heart disease, surgically constructed systemic-pulmonary shunts.

5
Q

Alternatives to penicillins include macrolides

A

T

6
Q

Appropriate antibiotics to prevent bacterial endocarditis in at risk patients are amoxicillin or if allergic, cefalexin, axithro or clindamicin

A
T
60min pre op
Amox 2g
Ceflex 2g
Azithro 500mg
Clinda 600mg
- same for immmunosuppressed pts who have been advised they need prophylaxis
7
Q

Heat electrocautery or bipolar coagulation should not be used in patients with implanted cardiac pacemakers.

A

F

These are advocated.

8
Q

The risk of cardiac conditions has been stratified into high, moderate, low or negligible risks by the American Heart Association

A

T

9
Q

Procedures involving infected or eroded skin are associated with significantly higher infection risk and warrant the use of prophylactic antibiotics.

A

T

10
Q

Lidocaine and prilocaine are the preferred anesthetics for use during pregnancy

A

T
cat A in Aus
(B in USA but stil preferred)

11
Q

Patients with hypertrophic cardiomyopathy and mitral valve prolapse with regurgitation are medium-risk for developing bacterial endocarditis following a surgical procedure.

A

T
High-risk categories include patients with prosthetic valves, a previous history of endocarditis, complex congenital cyanotic heart disease, and surgically constructed systemic–pulmonary shunts

12
Q

Antiviral prophylaxis for laser resurfacing should begin within 48hrs preoperatively and continue until re-epithelialisation is complete, generally within 7-10 days.

A

T

13
Q

Cephalospirin Abx can usually be given safely to penicillin allergic patients who do not have anyphylactic response to penicillin

A

T

14
Q

Garlic, ginseng, ginger, ginkgo, St John’s wort and feverfew are all potential anticoagulants.

A

T

15
Q

Electrocautery is the preferred method of haemostasis in patients with implanted deep-brain stimulators.

A

T

16
Q

Consider delaying surgery in hypertensive patients with a systolic pressure of >170 mmHg and/or a diastolic pressure >100 mmHg

A

T
bleeding risk and stroke risk
send to GP for BP lowering

17
Q

Lignocaine and prilocaine are the preferred anaesthetics for pregnancy.

A

T

18
Q

Dabigaptran (Pradaxa) is a factor Xa inhibitor

A

F

direct thrombin inhibitor

19
Q

Erythromycin estolate is safe to use during pregnancy.

A

F

Assoc with hepatotoxicity during pregnancy.

20
Q

Fondaparinux and Rivaroxiban are factor 9 (IX) inhibitors

A
F
factor 10a (Xa) inhibitors
21
Q

Inactivation of the deep-brain stimulator has never been necessary as effective hemostasis can be achieved with electrocautery in dermatologic surgery

A

T

22
Q

In pts with Hx of HSV undergoing facial resurfacing procedures antivral prophylaxis options include acyclovir 400 mg three times daily, valacyclovir 500 mg twice daily, and famciclovir 250 mg twice daily.

A

T

start 48 hrs before and continue until re-epithelialization 7-10 days after

23
Q

There are no adverse effects associated with bupivacaine and mepivacaine use in pregnancy. .

A

F

Associated with increased risk of foetal bradycardia

24
Q

Alcohol may result in an increased bleeding potential.

A

T

advise pts to avoid for 2 days prior to surgery and at least until day afterwards

25
Q

Use of the hyfrecator is acceptable in pts with deep brain stimulators

A
F
Use Electrocautery (hot wire)
26
Q

Patients with implanted pacemakers and defibrillators and patients with physiologic heart murmurs are low-risk for development of bacterial endocarditis following surgery.

A

T

27
Q

Intrapartum use of tetracycline may result in staining of foetal dental enamel.

A

T

28
Q

Small volumes of adrenaline-containing anaesthetics cannot be given safely in patients with advanced heart disease.

A

F
can be
must be max conc 1:200,000

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