Questions · Postoperative Nausea and Vomiting Prophylaxis
7 questions, 0 approved. Approve them one at a time — a quiz shows nothing you have not.
Recall — derived from a kept point
What are the four predictors in the simplified Apfel risk score, and what PONV incidence corresponds to each score from 0 to 4?
Answer: Female sex, a history of motion sickness or previous PONV, non-smoking status, and the expected use of postoperative opioids. With none, one, two, three or four of these present, the incidences of PONV were 10%, 21%, 39%, 61% and 79% respectively.
Four questions you can ask in the holding area produce a number. Two or more risk factors is where the original paper suggests prophylaxis should be considered.
Source claim: The simplified Apfel score consists of female gender, history of motion sickness or PONV, nonsmoking, and use of postoperative opioids; with none, one, two, three or four present, the incidences of PONV were 10%, 21%, 39%, 61% and 79%. The authors state that for patients with at least two of these four identified predictors a prophylactic antiemetic strategy should be considered.
Apfel et al., A simplified risk score for predicting postoperative nausea and vomiting, Anesthesiology 1999
recall · CA-1 · phrased by llm
The Apfel score has an area under the ROC curve of roughly 0.63 to 0.73. What does that tell you about how it should and should not be used?
Answer: That is modest discrimination — better than chance and enough to stratify a population into risk bands, but not enough to predict confidently which individual patient will vomit. It supports using the score to grade risk, rather than treating a low score as a reassurance about a particular patient.
A validated score with an AUC in the 0.7 range is a stratification tool, not a diagnostic test.
Source claim: The simplified PONV risk scores had areas under the receiver operating characteristic curve of 0.63 to 0.73, and the original scores 0.65 to 0.75.
Apfel et al., A simplified risk score for predicting postoperative nausea and vomiting, Anesthesiology 1999
recall · CA-2 · phrased by llm
The point with one number taken out. No model wrote any of this: the stem is the sentence you reviewed, minus a digit, and the paper it came from is named beneath it.
Open prompts
Walk me through your setup for this before we start.
open · CA-1 · phrased by derived
What are you watching on the monitor that would tell you this is going wrong?
open · CA-1 · phrased by derived
What is your first move if it does?
open · CA-1 · phrased by derived
What would you want ready in the room before induction?
open · CA-1 · phrased by derived
Questions only — nothing here asserts anything, which is why a model is allowed to phrase them. Where no model was reachable these are the level defaults.