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Copper Deficiency Myelopathy — RACP Adult Medicine MCQ

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HardNeurologyCopper Deficiency MyelopathyRACP Adult Medicine

A 68-year-old with stable coronary disease and good functional capacity is scheduled for elective colectomy. He has no angina, heart failure or high-risk stress-test indication. What is the most appropriate coronary strategy?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Proceed without coronary intervention unless an independent cardiac indication emerges

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · E = shown as D · B = shown as E

E is correct. Preoperative coronary testing or revascularisation is undertaken only when independently indicated or likely to change management, not merely to facilitate surgery. A and B expose the patient to procedural and antiplatelet harms. C overstates risk. D is not a validated stability assessment and delays care.

Reference: ANZCA, Standards of practice for perioperative medicine: https://www.anzca.edu.au/chapter-of-perioperative-medicine/standards-of-practice-for-perioperative-medicine