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 Pre-op work-up  

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What are the pre-op work-up of a 45 year-old female patient with long-standing rheumatoid artyhritis on mexothreate scheduled for a fem-fem bypass?


Hematocrait, CBC, CMP, Glucose, PT and PTT, S creatinine and BUN, LFTs


What about the most important test?


You forgot the most, most important pre-op tests !!!


You are the consultant in a community hospital and you were consulted to do a pre-op work-up.

Please give more specific pre-op work-up !


AAAAA wrote:
What are the pre-op work-up of a 45 year-old female patient with long-standing rheumatoid arthritis on mexothreate scheduled for a fem-fem bypass?

Most inflammtory diseases including rheumatoid diseases are classified as having cardiac risk factors !!


Question did not specify indication for bypass..
I may be missing something here..did you want echo or angio?
not sure.


Please review the pre-op work-up of medical patients with many medical problems going for major vascular surgery.

Those are very important stuff we have to review and I will give you the answer when you at least try to answer the question in a meaningful way !

Why the pt goes for fem-fem bypass, PVD !!


Question does not ask you for teh reason for the bypass, question ask you as a consultant what do you DO ?


As a consultant I would know the existing conditions, reason for bypass and natural history of disease progression.
Every single thing asked for pre-op had a reason that I am sure everyone can understand. and for sure I may be missing something important so let your knowledge be spread..


IN the case of PVD , the risk of comorbid coronary artery disease is 50%. in the regular basis there is no indication for assesment of coronary artery but in the pre op you must r/o it and if it sever you must treat it( maybe CABG ) before another operation. in this case ithink thallium scan is a good choice

whats your oponion AAAAA

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