Preoperative Risk Stratification, Cardiac/Pulmonary Optimization and Perioperative Risk Assessment — WACS Viva & Clinical Scenarios (General Anaesthesia)

Exam-style preoperative risk stratification, cardiac/pulmonary optimization and perioperative risk assessment viva scenarios with examiner probes and model…

Scenarios covered

• SCENARIO 1: A 64-year-old male with a history of anterior wall myocardial infarction 4 months ago and poorly controlled hypertension presents for elective open cholecystectomy. He cannot climb one flight of stairs without chest tightness. How will you evaluate, stratify, and optimize his cardiovascular risk prior to surgery?
• SCENARIO 2: A 58-year-old female with long-standing severe chronic obstructive pulmonary disease (COPD) and a 30 pack-year smoking history is scheduled for elective major upper abdominal surgery. She has an active productive cough and diffuse wheezes. How do you assess and optimize her respiratory status to mitigate postoperative pulmonary complications?
• SCENARIO 3: A 62-year-old hypertensive diabetic patient with end-stage renal disease on maintenance haemodialysis (last dialyzed 3 days ago) requires emergent laparotomy for acute sigmoid volvulus with signs of peritonitis. Outline your rapid preoperative assessment, risk stratification, and stabilization priorities.
• SCENARIO 4: A 70-year-old male who had a drug-eluting coronary stent placed 5 months ago for unstable angina is presenting for urgent transurethral resection of the prostate (TURP) due to intractable haematuria and clot retention. He is on Aspirin and Clopidogrel. How do you manage his antiplatelet therapy and perioperative risk?