Enhanced Recovery Protocols Practice Questions

Question 1

A patient with a non-obstructing carcinoma of the sigmoid colon is being prepared for elective resection. To minimize the risk of postoperative infectious complications, what should be included in your planning?

Accepted Answer

A single preoperative parenteral dose of antibiotic effective against aerobes and anaerobes may provide initial coverage.

Answer

Postoperative administration for 5 to 7 days of parenteral antibiotics effective against aerobes and anaerobes

Answer

Postoperative administration for 2 to 4 days of parenteral antibiotics effective against aerobes and anaerobes

Answer

Avoidance of oral antibiotics to prevent emergence of Clostridioides difficile

Question 2

After a major oral surgery, the acute catabolic phase lasts for?

Accepted Answer

2-5 days

Answer

1-2 days

Answer

4-7 days

Answer

5-10 days

Question 3

When do we have to start antibiotics to prevent post-operative infection?

Accepted Answer

30-60 minutes before incision (up to 24 hours post-op)

Answer

1 week before surgery

Answer

2 days before surgery

Answer

After surgery

Question 4

What is the treatment of choice for a post-operative abscess?

Accepted Answer

Image guided aspiration

Answer

Hydration

Answer

IV antibiotics

Answer

Reexploration

Question 5

In surgical stress all hormones are increased except:

Accepted Answer

Insulin

Answer

Epinephrine

Answer

ACTH

Answer

Cortisol

Question 6

Which of the following statements is NOT correct regarding total parenteral nutrition (TPN)?

Accepted Answer

In abdominal injury, early parenteral nutrition should be started after a minimum of 2 weeks of bowel rest

Answer

Lipids form 20-30% of energy source

Answer

Carbohydrates typically provide 40-60% of the energy source

Answer

Proteins typically provide around 10-15% of the energy source

Question 7

In emergency caesarian section rapid induction of anaesthesia is done to –

Accepted Answer

Prevent gastric aspiration

Answer

Prevent fetal depression

Answer

All of the above

Answer

To decrease awareness

Question 8

On the 4th postoperative day of laparotomy a patient presents with bleeding & oozing from the wound. Management is :

Accepted Answer

Dressing of wound & observe for dehiscence

Answer

Send for USG abdomen

Answer

Start treatments for peritonitis

Answer

IV fluids

Question 9

Which is not a feature of SIADH?

Accepted Answer

Low urine sodium

Answer

Urine Osmolality > 100 mosm/ kg

Answer

Treatment is fluid restriction

Answer

Euvolemia

Question 10

A 62-year-old man with drug-eluting stent placed 4 months ago requires urgent colonoscopy with polypectomy for a bleeding polyp. He is on dual antiplatelet therapy (aspirin and clopidogrel). Analysis of risks shows continued bleeding risk versus stent thrombosis risk. What is the most evidence-based management strategy?

Accepted Answer

Continue aspirin, discontinue clopidogrel 5 days before procedure

Answer

Discontinue clopidogrel only, add prophylactic heparin bridging

Answer

Discontinue both aspirin and clopidogrel 7 days before procedure

Answer

Continue both aspirin and clopidogrel throughout procedure

Enhanced Recovery Protocols — MCQs

Enhanced Recovery Protocols — MCQs

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