True or False
True or False: Bleeding is the most significant complication of orthopedic surgery
False: it is technically infection
Dr. Farina mentions it in her lecture
Which of the following statements about intraoperative evoked potential monitoring during spine surgery is CORRECT?
D) Hypothermia and hypotension can increase the latency of SSEPs during surgery.
Your patient is coming in to fix an emergency pelvic fracture. You are getting them ready to induce. While putting on leads you notice they are covered in petichiae. You look up at your monitor and they are only sating 89% on room air. What do you MOST LIKELY suspect is occurring?
A. DIC
B. Allergic reaction
C. fat emboli
D. Sepsis
C. Fat emboli
Which of the following are aims of the Surgical Care Improvement Project (SCIP)?
A. Cephazolin initiated within 1 hour of incision
B. Clindamycin and Vanco for B-lactam allergies can be used instead and should also be initiated within 1 hour of incision
C. maintain BG 140-180
D. maintain normothermia
A, C, D
B. is true except it can be initiated within 2 hours of incision not 1
Here is a link where you match the type of anticogulant to the standrds for Neuraxial/regional anesthesia (I feel like this will be important but I put it in this format because its easier to see)
A FRAIL score of 3-5 means the patient is experiencing Frailty.
(Bonus is you can list what each letter stands for)
True: 3-5 = frailty
1-2 = pre frail
0= robust health
(F= fatigue, R=resistance, A= ambulation, I- illness, L= loss of weight)
How long after initiation of the tourniquet does pain start?
A. 30 mins
B. 90 mins
C. 60 mins
D. 2 hours
C. 60 mins
you may see an increase in BP which becomes very hard to control
Which of the following are NOT risks of deflation of a tourniquet?
A. hypotension
B. increased K+ and myoglobin (metabolic waste)
C. transient hypercarbia and acidosis
D. transient hyperthermia and desaturation
D. its is HYPOTHERMIA and desat
Common patient traits seen in orthopedic trauma cases include: (Select all that apply)
A) Obesity, B) Rheumatoid arthritis, C) History of falls, D) Pediatric patients with deformities
How many days of consecutive use of unfractionated heparin should you check coags
A. 4 days
B. 10 days
C. 1 day
D. 6 days
A. 4 days
Ture or false: Streptococous aureus is the cause of most surgical site infections
False: it is Staph aureus
This is why MRSA decolonization with preadmission nasal swabs/spray (Mupirocinm Povidine-iodine 5%) is importnat since 80% of SSI come from patients own noses
Which of the following is not true regarding Knee Arthroscopy
A. usually done with general and a LMA
B. does not use a tourniquet
C. usually 60 minutes
D. local anesthesia can be injected into the joint for anesthesia
B. does not use a tourniquet
it does use a tourniquet
In managing anesthesia for prone-positioned spine surgery, what is the primary concern related to head positioning?
B) Compromised cerebral venous drainage
Which considerations are essential in preoperative assessment for elderly orthopedic patients? (Select all that apply)
A) Cardiopulmonary function, C) Skin fragility, D) Assessment of cognitive status, E) Nutritional status evaluation
This medication is a synthetic analogue of the amino acid lysine and competes for lysine receptors that activate plasminogen
Tranexamic acid
True or false: The silicone ring tourniquet has a timer on it that automatically deflates the periodically
False: this is the pneumatic tourniquet. You have to keep track of the time yourself
Which of the following is a major risk factor for postoperative visual loss (POVL) during spine surgery?
B. use of the wilson frame
During total shoulder arthroplasty in the beach chair position, what is the greatest risk associated with the surgical position?
Which of the following are major considerations for anesthesia management during spine surgery in the prone position? (Select all that apply)
A) Increased intra-abdominal pressure, B) Decreased stroke volume, D) Monitoring for facial edema, E) Frequent checks of the patient's head positioning
Potential barotrauma, bucking
Consider pressure control vs volume control, SIMV
This is a list of contraindications for TXA. State whether they are relative or absolute contraindications?
A. history of DVT/PE
B. Factor V leiden
C. coronary stents
D. SAH
E. active thrombosis
F. hypersensitivity
A. history of DVT/PE --> relative
B. Factor V leiden --> relative
C. coronary stents --> relative
D. SAH --> absolute
E. active thrombosis --> absolute
F. hypersensitivity --> absolute
True or False: Extracapsular hip fracture is associated with less blood loss than in comparison to intracapsular
False: intracapsular is associated with less blood loss
Which consideration is crucial for patients undergoing surgery for acute compartment syndrome?
D) Prioritizing fasciotomy as the definitive treatment
In the management of acetabular fractures, which of the following factors contributes most to intraoperative hemodynamic instability?
Which of the following are important considerations for the use of evoked potential monitoring during orthopedic spine surgery? (Select all that apply)
A) Low MAC inhaled agents are preferred to maintain SSEP signal amplitude, B) Motor evoked potentials (MEPs) are highly sensitive to inhaled anesthetics and neuromuscular blockade, D) A bite block is necessary during MEP monitoring to prevent tongue injuries
Which of the following statements about kyphoplasty is CORRECT?
C) It is indicated primarily for treatment of vertebral compression fractures.