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Perioperative Patient Management Flashcards

7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Perioperative Patient Management flashcards as text

  1. A 58-year-old patient with a recent drug-eluting coronary stent (placed 4 months ago) requires semi-urgent colon resection. What is the best antiplatelet management strategy?

    Answer: Continue aspirin; consider continuing P2Y12 inhibitor or bridge with cangrelor/tirofiban after multidisciplinary discussion

    Drug-eluting stents require dual antiplatelet therapy for at least 12 months; semi-urgent surgery within that window requires cardiology input, continuation of aspirin, and individualized P2Y12 management.

  2. Which parameter BEST predicts fluid responsiveness in a mechanically ventilated patient without arrhythmia?

    Answer: Pulse pressure variation (PPV) > 13%

    PPV > 13% in a fully mechanically ventilated patient without arrhythmia or right heart failure is the most validated dynamic predictor of fluid responsiveness.

  3. A patient undergoing spine surgery in the prone position develops sudden hypotension and bradycardia after a previously stable 3-hour course. The MOST likely cause is:

    Answer: Venous air embolism

    Venous air embolism can occur in prone spine surgery due to the elevated operative field creating negative venous pressure; it presents with sudden cardiovascular collapse and mill-wheel murmur.

  4. In a patient with morbid obesity (BMI 52) undergoing bariatric surgery, which ventilation strategy reduces postoperative pulmonary complications MOST effectively?

    Answer: Low tidal volume (6–8 mL/kg IBW) with PEEP 8–10 cmH₂O and recruitment maneuvers

    Lung-protective ventilation using IBW-based tidal volumes, moderate PEEP, and periodic recruitment maneuvers reduces atelectasis and PPCs in obese patients.

  5. Postoperative nausea and vomiting (PONV) prophylaxis with ondansetron works primarily by:

    Answer: Blocking 5-HT₃ receptors in the chemoreceptor trigger zone and vagal afferents

    Ondansetron is a selective 5-HT₃ antagonist that blocks serotonin-mediated signaling in the CTZ and peripheral vagal afferents responsible for nausea.

  6. A 65-year-old patient with ESRD on hemodialysis requires a parathyroidectomy. Which muscle relaxant is SAFEST to use?

    Answer: Cisatracurium

    Cisatracurium undergoes Hofmann elimination and ester hydrolysis independent of renal or hepatic function, making it the safest NMBD in ESRD.

  7. Which criterion is part of the modified Aldrete score used to determine PACU discharge readiness?

    Answer: Activity, respiration, circulation, consciousness, and SpO₂

    The modified Aldrete score evaluates five criteria (activity, respiration, circulation, consciousness, oxygen saturation), each scored 0–2, with discharge at ≥ 9.