Pre-Op Evaluation/Management

 - also see PreOp Eval

Low-risk patients: (Do Not need noninvasive cardiac testing)


Source: ITE 2013, Q50

A 63-year-old male presents for a preoperative evaluation prior to total knee arthroplasty. He underwent coronary artery angioplasty and stent placement 3 years ago following an episode of angina and an abnormal exercise stress test. His current medications include aspirin, atorvastatin (Lipitor), and lisinopril (Prinivil, Zestril). He runs 2 miles three times/week without difficulty. He has no history of heart failure, diabetes mellitus, kidney disease, or cerebrovascular disease. An EKG and preoperative blood tests, including kidney function tests, are normal.
Which one of the following is indicated prior to surgery to decrease this patient’s perioperative risk?
A) Performing noninvasive cardiac stress testing
B) Continuing his statin therapy
C) Discontinuing aspirin
D) Starting a -blocker
E) Starting clopidogrel (Plavix)

ITE 2014, Q 164.
A 60-year-old male is scheduled for coronary revascularization. Which one of the following would reduce his cardiovascular risk the most when given perioperatively?

A) Beta-Blockers
B) Calcium channel blockers
C) Statins
D) Aspirin
E) Warfarin (Coumadin)

ANSWER: C