Pre, intra and post- operative management.
General Surgery · Topic 10
Source: NMC CBME Curriculum 2024 · Volume III · General Surgery · Topic 10 · combined PDF page 405
Practice questions
- In the UK preoperative smoking-cessation pathway, what happened to patients who did not respond to the SMS invitation within 14 days?
- Which patients were eligible for the SMS-based preoperative smoking intervention described in the study?
- What was the primary abstinence outcome in the SMS referral study?
- Fifty of 258 contactable patients who confirmed smoking reported stopping. Which percentage corresponds to this denominator?
- In the study of 476 preoperative patients, 50 reported 28-day abstinence. What was the reported abstinence proportion using the entire cohort as the denominator?
- Which design feature was used to assess whether changes in abstinence among hospital referrals reflected general time trends?
- The controlled interrupted time series found an immediate increase of 5.83 weekly hospital patients referred who later reported abstinence (95% CI 2.50–9.16; p<0.001). Which interpretation is most appropriate?
- Which limitation most directly cautions against treating the reported abstinence rate as a definitive causal effect of the SMS pathway?
- An older patient with a hip fracture receives a fascia iliaca compartment block before surgery. In the retrospective study, which comparison group does this patient match?
- What was the reported incidence of postoperative delirium in the preoperative FICB group compared with the intraoperative FICB group?
- How was postoperative delirium assessed in the elderly hip-fracture FICB study?
- Which instrument was used to assess pain intensity in the FICB study?
- Which statement best describes the reported VAS pain findings after preoperative versus intraoperative FICB?
- Both FICB groups received 50 mL of 0.25% ropivacaine. What total dose of ropivacaine does this represent?
- Which statement correctly distinguishes the cognitive measures used in the FICB study?
- The preoperative FICB group had higher MMSE scores on postoperative days 1–3. Which interpretation is most appropriate?
- Which statement about inflammatory markers in the FICB study is supported by the reported results?
- A clinician concludes that preoperative FICB definitively prevents postoperative delirium because delirium was less frequent in that group. What is the strongest methodological objection?
- In the 24-year cohort of patients undergoing surgical repair of post-infarction VSR, what was the overall 30-day mortality?
- Which perioperative IABP finding was independently associated with lower 30-day mortality in the VSR cohort?
- For postoperative IABP use in the VSR cohort, the adjusted odds ratio for 30-day mortality was 0.014 (95% CI 0.001–0.120; p=0.001). Which interpretation is best?
- Preoperative IABP use had an odds ratio of 0.161, a 95% confidence interval of 0.016–1.062, and p=0.077. Which conclusion is most accurate?
- Which patients were included in the VSR perioperative IABP cohort?
- Which observation about timing was reported among nonsurvivors in the VSR surgical cohort?
- A report notes longer delays to surgery among nonsurvivors and a lower mortality association with postoperative IABP. Which conclusion is most defensible?
- Which statement correctly describes the distribution of IABP support in the VSR cohort?
- A trainee interprets an odds ratio of 0.014 for postoperative IABP as a 98.6-percentage-point reduction in mortality. What is the key error?
- Which statement about the role of surgery in the post-infarction VSR cohort is supported by the report?
- A patient with post-infarction VSR is managed conservatively without repair. How directly do the cohort's IABP findings apply to this patient?