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Preoperative Considerations

Which of the following statements regarding a preoperative internal medical consultation is FALSE?

a. It provides medical clearance for surgery.

b. It can discover previously undiagnosed diseases.

c. It provides a risk assessment of a patient’s current medical state.

d. It can help optimize a patient’s existing medical conditions prior to surgery.

A 39-year-old woman is undergoing laparotomy for a large pelvic mass. Her history is significant for obesity and well-controlled asthma. Due to the mass size, it is necessary to extend the vertical midline incision above the umbilicus. The surgery takes 4 hours to perform, and the total estimated blood loss is 500 mL. Which of the following does NOT increase her risk of pulmonary complications postoperatively?

a. Asthma

b. Obesity

c. Length of incision

d. Duration of surgery

This patient will be at increased risk for atelectasis following total laparoscopic hysterectomy. This is due to which of the following associated physiologic changes stemming from her body habitus?

a. Decreased chest wall compliance

b. Increased expiratory reserve volume

c. Increased functional residual capacity

d. Increased maximum voluntary ventilation

A 50-year-old woman with endometrial cancer presents for preoperative evaluation and planning for surgical staging. Her history is significant for a 30-pack-year smoking history. Which of the following statements should be included in counseling for smoking cessation?

a. Preoperative cessation for at least 6 to 8 weeks offers significant improvement in lung function.

b. Preoperative cessation for at least 6 to 8 weeks offers reversal of smoking-related immune impairment.

c. Patients with a 6-month or longer history of cessation have pulmonary complication risks similar to patients who have never smoked.

d. All of the above

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