PG Test July 31, 2025

According to the Revised Cardiac Risk Index (RCRI), what is his estimated risk of a major adverse cardiac event (MACE)?

• 0.4%

• 0.9%

• 6.6%

• 11%

• >20%

What is the most critical perioperative concern in her management?

• Avoidance of general anesthesia

• Risk of pulmonary embolism

• Risk of fluid overload and digitalis toxicity

• Avoidance of beta-blockers

• Prophylactic antibiotics

What is the most important perioperative anesthetic consideration?

• Induce hypotension to avoid ischemia

• Avoid heart rate reduction

• Maintain afterload and avoid tachycardia

• Use halothane for vasodilation

• Delay surgery for 6 months

What is the recommended anticoagulation strategy for this patient?

• Discontinue warfarin 7 days prior

• Continue warfarin and proceed

• Bridge with LMWH after stopping warfarin

• Use aspirin instead of warfarin

• Delay surgery indefinitely

What is the next best step in management?

• Administer IV atropine

• Try carotid massage and Valsalva

• Administer IV adenosine

• Give oral beta blockers

• Wait and observe

What is the most appropriate action?

• Proceed with surgery under local anesthesia

• Start IV hydralazine

• Reschedule and refer for blood pressure control

• Administer clonidine

• Monitor blood pressure every 10 minutes

What is the most significant perioperative concern?

• Bronchospasm during intubation

• Reduced FiO₂ delivery

• Risk of infection

• Increased risk due to recent smoking cessation

• Need for vasopressors

Which is the most appropriate perioperative strategy?

• Continue oral hypoglycemics

• Admit for insulin infusion and glucose monitoring

• Cancel surgery permanently

• Prescribe corticosteroids pre-op

• Use oral glucose tolerance test pre-op

What should be done before proceeding with general anesthesia?

• Proceed without delay

• Give corticosteroid burst and postpone surgery

• Switch to local anesthesia

• Administer only beta agonists

• Refer to cardiology

What is the first-line treatment?

• Start oral kayexalate

• Emergency dialysis

• Administer calcium gluconate IV

• Infuse IV fluids

• Administer sodium bicarbonate only