SX Exam 1 Latest Update 2025/2026
When is a pre-op evaluation typically done? - ANSWER within 1 week of sx date
What is done during the "timeout" prior to starting an operation? - ANSWER announce pt
name, MRN, and procedure to be done
identify each member of the operative team
How are most surgical trays and steel instruments sterilized? - ANSWER autoclaving
(steam and pressure)
How are most pre-packaged items (sponges, sutures, drapes, etc.) typically sterilized? -
ANSWER ionizing radiation
How are pieces of equipment that cannot be autoclaved (cameras, scopes, plastic)
typically sterilized? - ANSWER gas - ethlene oxide with CO2 or freon
In what order should you clean you arms when scrubbing in? - ANSWER start with nails,
then fingers, palms/backs of hands, forearm, elbow, finish a few inches above the elbow
What is the order you put on equipment when scrubbing in for sx? - ANSWER bouffant
cap and mask on before entering OR
scrub in
put on gown
put on gloves
Which antiseptic is the most protective against post op infections? - ANSWER
Chloraprep (chlorhexidine)
What are Weitlander, Richardson, and Bookwalter examples of and what are they used
for? - ANSWER retractors - for holding back tissue
What is a needle driver used for? - ANSWER holds the suture needle
What is an Adson? What is it used on - ANSWER foreceps with teeth - used on skin
What is a Bovie? - ANSWER electro-cautery tool
What is a Hemostat? - ANSWER clamp
What is a Debakey? What is it used for? - ANSWER smooth forceps, used for tissue
What are Metzenbaum scissors? - ANSWER angled blunt tip scissors for cutting tissue
When should you do an ECG as part of a pre-op eval? - ANSWER everyone >40, anyone
, with cardiac hx
What do the ASA classifications refer to? - ANSWER status of the pt pre-op
1: normal healthy pt
2: mild systemic disease
3: severe systemic disease
4: severe systemic, constant threat to life
5: not expected to survive w/o operation
6: braindead
What two hormones increase during sx? - ANSWER ADH and ACTH
ADH tells kidneys to keep water due to volume loss during sx
ACTH stims release of cortisol due to stress
What happens to blood glucose during sx? - ANSWER increases
What is a major risk to the lungs during long surgeries? - ANSWER atelectasis
How long does ACTH typically remain elevated post-op? - ANSWER 1-2 days
How long does ADH typically remain elevated post-op? - ANSWER 2-4 days (diuresis
typically begins day 3)
What type of anesthesia is preferred in pts with pulmonary conditions? - ANSWER spinal
or regional anesthesia
general anesthesia has a higher rate of respiratory failure due to decreased resp drive
What labs/imaging could you consider for pre-op eval for a pt with a lung condition? -
ANSWER baseline CXR, PFTs, ABG
What pre-treatment can be given to pts with asthma or COPD prior to sx? - ANSWER
bronchodilators and steroids - as needed
What can be given to cardiac pts 1 week pre-op? - ANSWER beta blockers - atenolol or
bisoprolol
this reduces risk of post-op MI, angina, CHF, death
When is the peak incidence of post-op MI? - ANSWER at 48 hours - when ACTH levels
are elevated
What are two common causes of post-op morbidity in pts with renal disease? - ANSWER
hyperkalemia/arrhythmias, infection/sepsis
When is a pre-op evaluation typically done? - ANSWER within 1 week of sx date
What is done during the "timeout" prior to starting an operation? - ANSWER announce pt
name, MRN, and procedure to be done
identify each member of the operative team
How are most surgical trays and steel instruments sterilized? - ANSWER autoclaving
(steam and pressure)
How are most pre-packaged items (sponges, sutures, drapes, etc.) typically sterilized? -
ANSWER ionizing radiation
How are pieces of equipment that cannot be autoclaved (cameras, scopes, plastic)
typically sterilized? - ANSWER gas - ethlene oxide with CO2 or freon
In what order should you clean you arms when scrubbing in? - ANSWER start with nails,
then fingers, palms/backs of hands, forearm, elbow, finish a few inches above the elbow
What is the order you put on equipment when scrubbing in for sx? - ANSWER bouffant
cap and mask on before entering OR
scrub in
put on gown
put on gloves
Which antiseptic is the most protective against post op infections? - ANSWER
Chloraprep (chlorhexidine)
What are Weitlander, Richardson, and Bookwalter examples of and what are they used
for? - ANSWER retractors - for holding back tissue
What is a needle driver used for? - ANSWER holds the suture needle
What is an Adson? What is it used on - ANSWER foreceps with teeth - used on skin
What is a Bovie? - ANSWER electro-cautery tool
What is a Hemostat? - ANSWER clamp
What is a Debakey? What is it used for? - ANSWER smooth forceps, used for tissue
What are Metzenbaum scissors? - ANSWER angled blunt tip scissors for cutting tissue
When should you do an ECG as part of a pre-op eval? - ANSWER everyone >40, anyone
, with cardiac hx
What do the ASA classifications refer to? - ANSWER status of the pt pre-op
1: normal healthy pt
2: mild systemic disease
3: severe systemic disease
4: severe systemic, constant threat to life
5: not expected to survive w/o operation
6: braindead
What two hormones increase during sx? - ANSWER ADH and ACTH
ADH tells kidneys to keep water due to volume loss during sx
ACTH stims release of cortisol due to stress
What happens to blood glucose during sx? - ANSWER increases
What is a major risk to the lungs during long surgeries? - ANSWER atelectasis
How long does ACTH typically remain elevated post-op? - ANSWER 1-2 days
How long does ADH typically remain elevated post-op? - ANSWER 2-4 days (diuresis
typically begins day 3)
What type of anesthesia is preferred in pts with pulmonary conditions? - ANSWER spinal
or regional anesthesia
general anesthesia has a higher rate of respiratory failure due to decreased resp drive
What labs/imaging could you consider for pre-op eval for a pt with a lung condition? -
ANSWER baseline CXR, PFTs, ABG
What pre-treatment can be given to pts with asthma or COPD prior to sx? - ANSWER
bronchodilators and steroids - as needed
What can be given to cardiac pts 1 week pre-op? - ANSWER beta blockers - atenolol or
bisoprolol
this reduces risk of post-op MI, angina, CHF, death
When is the peak incidence of post-op MI? - ANSWER at 48 hours - when ACTH levels
are elevated
What are two common causes of post-op morbidity in pts with renal disease? - ANSWER
hyperkalemia/arrhythmias, infection/sepsis
