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Preoperative Considerations

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

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a. It provides medical clearance for surgery.

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b. It can discover previously undiagnosed diseases.

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

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

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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?

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a. Asthma

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b. Obesity

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c. Length of incision

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d. Duration of surgery

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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?

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a. Decreased chest wall compliance

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b. Increased expiratory reserve volume

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c. Increased functional residual capacity

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d. Increased maximum voluntary ventilation

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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?

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

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

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

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d. All of the above

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