1|Page
ABSITE Exam Preparation Version 2 Newest Verified
Exam With Complete Questions And Correct Detailed
Answers| Newest Exam!!!
Minimum FEV1 for pneumonectomy? For lobectomy? For
wedge resection? - Answers-Pneumonectomy: FEV1 > 2 L
Lobectomy: FEV1 > 1.5L
Wedge resection: FEV1 > 0.8L
A 78-year-old man is brought to your office in a wheelchair.
He says his abdominal wall hernia has been getting bigger
and wonders if he needs surgery. He looks thin and pale,
but in no distress. He is mildly hypertensive (150/90), had
a CABG 3 years prior, and is on a statin and a diuretic. He
feels weak, his appetite is poor, and he lives in a skilled
nursing facility. He has a 10x8 non- incarcerated midline
incisional hernia. His postoperative risk is best determined
by which of the following?
A. Echocardiogram
B. Pulmonary function testing
C. Frailty index
D. Serum electrolytes
E. Abdominal CT scan - Answers-C.
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Frailty has gained in importance as a predictor of post-
operative outcomes, especially in the geriatric population.
The frailty index includes functional, nutritional and
Charlson Comorbidity Index. This patient had a moderate
cardiac risk. His procedure is elective and a frailty
assessment would likely make him a significant risk.
A 56-year-old female is scheduled to undergo a total
thyroidectomy for papillary carcinoma. She is currently
taking warfarin (Coumadin) 5 mg daily due to a femoral
DVT 4 months ago. Her current INR is 2.9. Regarding her
anticoagulation regimen, what is the most appropriate
course of action before surgery?
A. Decrease Coumadin dose to 1 mg daily 7 days before
surgery.
B. Decrease Coumadin dose to 1 mg daily 5 days before
surgery.
C. Stop Coumadin 7 days before surgery.
D. Stop Coumadin 5 days before surgery.
E. Stop Coumadin 3 days before surgery. - Answers-D
The usual recommendation is to withhold warfarin starting
4 to 5 days preoperatively (if the INR is between 2.0 and
3.0) to allow the INR to decrease to less than 1.5, which is
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a level considered safe for surgical procedures and
neuraxial blockade. Only if the INR is greater than 3.0 is it
usually necessary to stop warfarin longer than 4 to 5 days.
If the INR is higher than 1.8 the day of surgery, a small
dose of vitamin K (1 to 5 mg administrated orally or
subcutaneously) can reverse anticoagulation.
A 61-year-old male with pancreatic cancer presents for
preoperative evaluation prior to pancreaticoduodenectomy.
He is unable to walk two city blocks. His history is
significant for GERD, hyperlipidemia and diabetes
mellitus. Which of the following is an indication that this
patient should undergo a preoperative echocardiogram?
A. Inability to walk two blocks
B. History of diabetes mellitus
C. History of hyperlipidemia
D. Age over 60 years
E. High-risk surgical procedure - Answers-A
Echocardiography testing preoperatively should be used
selectively in patients at high risk for cardiac complications
perioperatively. This includes patients who are unable to
achieve four metabolic equivalents (METs), defined as
climbing two flights of stairs or walking four city blocks.
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Achieving less than 4 METs indicates poor cardiac
reserve, and echocardiogram is indicated before
intermediate or major risk surgery. Diabetes,
hyperlipidemia, age, and the operation risk are not
reasons for preoperative echocardiography.
A 75-year-old man complains of severe rest pain in his
right leg. He has no pulse in the femoral artery or below
with an ABI index of .2, but no gangrene. He has pulses in
the left leg. His BP is 150/80 mmHg, pulse 60 bpm, RR 18
breaths/min. He is on clopidogrel (Plavix), a beta blocker,
and a statin. His EKG and echocardiogram show no acute
changes and his ejection fraction is 60%. Which of the
following medications should he receive the day of
surgery?
A. Beta blocker alone
B. Clopidogrel and statin
C. Beta blocker and statin
D. Beta blocker, statin, and low molecular weight heparin
E. ACE inhibitor, aspirin, and statin - Answers-D
Beta blockers and statins have been demonstrated to
lower cardiac risk and should be continued perioperatively.
Clopidogrel (Plavix) is difficult to reverse and should be
ABSITE Exam Preparation Version 2 Newest Verified
Exam With Complete Questions And Correct Detailed
Answers| Newest Exam!!!
Minimum FEV1 for pneumonectomy? For lobectomy? For
wedge resection? - Answers-Pneumonectomy: FEV1 > 2 L
Lobectomy: FEV1 > 1.5L
Wedge resection: FEV1 > 0.8L
A 78-year-old man is brought to your office in a wheelchair.
He says his abdominal wall hernia has been getting bigger
and wonders if he needs surgery. He looks thin and pale,
but in no distress. He is mildly hypertensive (150/90), had
a CABG 3 years prior, and is on a statin and a diuretic. He
feels weak, his appetite is poor, and he lives in a skilled
nursing facility. He has a 10x8 non- incarcerated midline
incisional hernia. His postoperative risk is best determined
by which of the following?
A. Echocardiogram
B. Pulmonary function testing
C. Frailty index
D. Serum electrolytes
E. Abdominal CT scan - Answers-C.
,2|Page
Frailty has gained in importance as a predictor of post-
operative outcomes, especially in the geriatric population.
The frailty index includes functional, nutritional and
Charlson Comorbidity Index. This patient had a moderate
cardiac risk. His procedure is elective and a frailty
assessment would likely make him a significant risk.
A 56-year-old female is scheduled to undergo a total
thyroidectomy for papillary carcinoma. She is currently
taking warfarin (Coumadin) 5 mg daily due to a femoral
DVT 4 months ago. Her current INR is 2.9. Regarding her
anticoagulation regimen, what is the most appropriate
course of action before surgery?
A. Decrease Coumadin dose to 1 mg daily 7 days before
surgery.
B. Decrease Coumadin dose to 1 mg daily 5 days before
surgery.
C. Stop Coumadin 7 days before surgery.
D. Stop Coumadin 5 days before surgery.
E. Stop Coumadin 3 days before surgery. - Answers-D
The usual recommendation is to withhold warfarin starting
4 to 5 days preoperatively (if the INR is between 2.0 and
3.0) to allow the INR to decrease to less than 1.5, which is
,3|Page
a level considered safe for surgical procedures and
neuraxial blockade. Only if the INR is greater than 3.0 is it
usually necessary to stop warfarin longer than 4 to 5 days.
If the INR is higher than 1.8 the day of surgery, a small
dose of vitamin K (1 to 5 mg administrated orally or
subcutaneously) can reverse anticoagulation.
A 61-year-old male with pancreatic cancer presents for
preoperative evaluation prior to pancreaticoduodenectomy.
He is unable to walk two city blocks. His history is
significant for GERD, hyperlipidemia and diabetes
mellitus. Which of the following is an indication that this
patient should undergo a preoperative echocardiogram?
A. Inability to walk two blocks
B. History of diabetes mellitus
C. History of hyperlipidemia
D. Age over 60 years
E. High-risk surgical procedure - Answers-A
Echocardiography testing preoperatively should be used
selectively in patients at high risk for cardiac complications
perioperatively. This includes patients who are unable to
achieve four metabolic equivalents (METs), defined as
climbing two flights of stairs or walking four city blocks.
, 4|Page
Achieving less than 4 METs indicates poor cardiac
reserve, and echocardiogram is indicated before
intermediate or major risk surgery. Diabetes,
hyperlipidemia, age, and the operation risk are not
reasons for preoperative echocardiography.
A 75-year-old man complains of severe rest pain in his
right leg. He has no pulse in the femoral artery or below
with an ABI index of .2, but no gangrene. He has pulses in
the left leg. His BP is 150/80 mmHg, pulse 60 bpm, RR 18
breaths/min. He is on clopidogrel (Plavix), a beta blocker,
and a statin. His EKG and echocardiogram show no acute
changes and his ejection fraction is 60%. Which of the
following medications should he receive the day of
surgery?
A. Beta blocker alone
B. Clopidogrel and statin
C. Beta blocker and statin
D. Beta blocker, statin, and low molecular weight heparin
E. ACE inhibitor, aspirin, and statin - Answers-D
Beta blockers and statins have been demonstrated to
lower cardiac risk and should be continued perioperatively.
Clopidogrel (Plavix) is difficult to reverse and should be
