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Internal Medicine · USMLE Step 3

USMLE Step 3 Perioperative Medicine

Preoperative risk assessment and perioperative medical management as tested on USMLE Step 3.

40 cards · basic cards · AI-written, checked twice. Edit anything.

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What clinical prediction tool estimates a patient's risk of a major cardiac event during noncardiac surgery using six risk factors?
The Revised Cardiac Risk Index (RCRI)
In the RCRI, what serum creatinine level counts as a risk factor?
Serum creatinine greater than 2.0 mg/dL
In the RCRI, which type of diabetes management counts as a risk factor?
Insulin-dependent diabetes mellitus
In the RCRI, a history of what neurologic condition counts as a risk factor?
Cerebrovascular disease (prior stroke or TIA)
In the RCRI, a history of what cardiac condition counts as a risk factor?
Ischemic heart disease
Which categories of surgery count as 'high-risk surgery' in the RCRI?
Intraperitoneal, intrathoracic, or suprainguinal vascular surgery
In the RCRI, a history of what condition involving fluid overload counts as a risk factor?
Congestive heart failure
How does the RCRI risk of a major cardiac event change as the number of present risk factors increases?
Risk of a major perioperative cardiac event rises with each additional risk factor present
What does ASA Physical Status Class I describe?
A normal, healthy patient
What does ASA Physical Status Class II describe?
A patient with mild systemic disease
What does ASA Physical Status Class III describe?
A patient with severe systemic disease
What does ASA Physical Status Class IV describe?
A patient with severe systemic disease that is a constant threat to life
What does ASA Physical Status Class V describe?
A moribund patient not expected to survive without the operation
What does ASA Physical Status Class VI describe?
A brain-dead patient whose organs are being removed for donation
What MET (metabolic equivalent) level is used as the threshold for adequate functional capacity before noncardiac surgery?
4 METs

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