Fellowship - periop resp Flashcards
A patient with primary pulmonary hypertension is scheduled for laparoscopic bowel resection. Their current medication is bosentant PO 125mg BD. Discuss how their condition influences your perioperative management
A 24-year-old female with cystic fibrosis is scheduled to undergo elective breast surgery. How does the presence of cystic fibrosis affect your perioperative management of this patient for this procedure?
How do you determine if a patient with known obstructive sleep apnoea is suitable for day surgery?
“A patient with known primary pulmonary hypertension is scheduled to undergo elective umbilical hernia repair. How will you assess the severity of this patient’s pulmonary hypertension? (50%) How does this diagnosis affect your perioperative
management of this patient? (50%) “
“A patient with known idiopathic pulmonary fibrosis (fibrosing alveolitis) presents for an open right hemicolectomy.(a) What are the respiratory issues facing this patient with regard to their general anaesthetic? (70%)(b) Explain your intraoperative ventilation
strategy. (30%)”
As the on-duty specialist anaesthetist, you are asked to see a previously well 64 year-old man in the PACU with SpO2 of 85% two hours after laparoscopic right partial nephrectomy during which he lost 1 litre of blood.a) List the likely causes of the desaturation? (30%)b) Outline your approach to managing the patient’s hypoxaemia. (70%)
A 78-year-old female presents for fixation of a displaced femoral fracture. She has longstanding mitral regurgitation and is known to have a mean pulmonary artery pressure of 60mmHg. She reports orthopnoea but is not short of breath at rest. (a) What are the issues of concern in your preoperative assessment? (50%) (b) How would you manage pulmonary vascular resistance perioperatively? (50%)
