NMS Q&A Family Medicine

SECTION XIIIPreventive HealthCarechapter 37Preoperative ClearanceExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 65-year-old male has scheduled elective kneereplacement surgery. Fifteen days before theappointed date, he was diagnosed as having stableangina and underwent anterior descending coronarystent placement 1 week before the replacement was tohave been performed. There was no evidence of myocardialinfarction (MI). The patient is a nonsmokerand his blood pressure is 128/78. When would it besafe to carry on with the knee replacement?(A) Immediately upon being pronounced as stablepost-stent procedure(B) One week after stent placement(C) Two weeks after stent placement(D) Six weeks after stent placement(E) Three months after stent placement2 Each of the following operations except for whichone confers at least a 5% risk of perioperative coronaryevents?(A) Surgery involving valvular heart disease(B) Emergency abdominal exploration for suspectedruptured viscus(C) Peripheral vascular surgery(D) Aortic surgery3 A 45-year-old female patient with a history of smokingis to undergo a thoracotomy to biopsy a coinlesion. The patient denies wheezing and shortness ofbreath. Which of the following is the bare minimumrequirement for preoperative pulmonary evaluationin this patient who will be operated upon under generalanesthesia?(A) Arterial blood gases(B) Digital oxygen saturation(C) Standard spirometry(D) Examination to rule out decreased breathsounds, prolonged expiratory phase, and adventitioussounds(E) Chest posteroanterior and left lateral x-ray4 A 58-year-old Caucasian man had an interruptedMI (thrombolysis) 5 years ago and must undergocolon resection for a malignant polyp at stage B bybiopsy during colonoscopy. His medications areatenolol, amlodipine, lisinopril, hydrochlorothiazide/triamterene(Hctz/tmp, Dyazide), and clonidine.Which of the following should be held on the day ofsurgery?227