346 Obstetrics and Gynecology Board Review •••
❍ What percentage of the United States population is affected by asthma?
Approximately 5%.
❍ Why has morbidity and mortality due to asthma increased in the recent years?
This is probably due to under diagnosis and under treatment.
❍ What should be the preoperative workup of the asthmatic patient?
Pulmonary examination, chest X-ray, and pulmonary function testing should be performed with and without
bronchodilators (arterial blood gases in select cases).
❍ What role do corticosteroids have in the management of asthma?
In curtailing the significant inflammatory component of asthma that is not treated by b-agonists.
❍ What is the single most significant reversible risk factor for pulmonary complications?
Tobacco smoke that quadruples risk of pulmonary complications.
❍ What duration of smoking cessation is necessary to significantly lower the incidence of pulmonary
complications?
2 months.
❍ What screening test should be used when suspecting diabetes mellitus or glucose intolerance?
A 2 hour 75 g glucose tolerance test.
❍ In what age group, is the highest incidence of major surgeries being performed?
Between 60 and 69 years of age.
❍ What type of musculoskeletal evaluation should be performed in the preoperative phase?
Back, hip, or lower extremity pathology should be assessed since often patients need to be in the dorsolithotomy
position.
❍ What measures can be taken to avoid neurological injury to operative patients?
Proper positioning and padding.
❍ What duration of gonadotropin releasing hormone agonist use has been associated with the maximum
decrease of uterine leiomyomata size?
3 months.
❍ How should patients with liver disease and elevated prothrombin time be prepared in the preoperative
stage?
The etiology of liver insufficiency should be investigated. Vitamin K 10 mg IM for 3 days should correct the
prothrombin time. Electrolytes, LFTs, BUN, serum creatinine, platelet count, and PTT should be checked.