Randomised SAQs 06-24.1 (No Answers) Flashcards
Revise SAQs
Outline the principles of cardiopulmonary exercise testing (50%) b) Evaluate the role of cardiopulmonary exercise testing in a patient who is scheduled for oesophagectmony (50%)
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In a patient who complains of post operative pain, which features of the history and examination suggest a diagnosis of acute neuropathic pain? (50%) b. How would the diagnosis affect your postoperative pain management plan? (50%)
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Discuss the options for anticoagulation management in the perioperative period for a patient taking warfarin for atrial fibrillation who requires a laparotomy for ischaemic bowel.
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With regard to oxygen therapy for patients in a general postoperative ward a. Describe the options available (30%) b. What are the justifications for your choice for a particular patient? (70%)
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A 45-year-old man with a longstanding history of alcoholism is booked for upper gastrointestinal endoscopy and banding of oesophageal varices following an episode of haematemesis. (a) How is the severity of this patient’s liver disease assessed? (50%) (b) How do these findings influence your evaluation of this patient’s perioperative risk? (50%)
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Evaluate the use of five (5) of the following additives that may be combined with local anaesthetics for neural blockade. adrenaline clonidine dexamethasone glucose hyaluronidase midazolam morphine neostigmine sodium bicarbonate
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A 75-year-old man is scheduled for elective endovascular repair of a thoraco-abdominal aortic aneurysm. List the potential complications of this procedure in this patient and discuss your strategies to mitigate these complications
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Patient is complaining of central chest pain in the post anaesthesia care unit (PACU) following femoro-popliteal artery bypass surgery. Outline the diagnostic criteria for acute myocardial ischaemia on an ECG? (30%) Describe your management of acute myocardial ischemia in PACU in this patient. (70%)
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While performing an epidural for labour analgesia in an otherwise healthy primigravida in first stage you inadvertently cause a dural puncture with the Touhy needle. Describe and justify your management of this complication.
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Describe the clinical features and treatment of fat embolism syndrome
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You are asked to assess and anaesthetise a 54-year-old patient for a laparoscopic cholecystectomy. They received a heart transplant ten years ago. Discuss the issues relevant for this patient.
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The T-Piece is obsolete in modern anaesthesia practice. Discuss.
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List the risks associated with the placement of a central venous catheter? Discuss the ways in which these risks may be modified.
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List the risk factors for postoperative nausea and vomiting (PONV) (30%) Evaluate methods to minimise PONV (70%)
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A 60-year-old woman is having breast reconstruction surgery using a deep inferior epigastric perforator free flap six months following a mastectomy for breast cancer. Discuss the issues of anaesthetic management relevant for this procedure.
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How do you assess an otherwise well patient with regard to difficulty of intubation at the bedside? How accurate is such an assessment?
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Describe the pathophysiological effects associated with the use of a pneumatic limb tourniquet and how they can be minimised.
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A 2 year old child has burns to lower body from immersion into a hot bath. Describe your assessment and management of pain and fluid requirements in the first 2 hours following injury.
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Discuss the management of cerebral vasospasm following coiling of a cerebral aneurysm
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A 63-year-old patient presents for urgent cancer surgery three weeks following myocardial infarction. Discuss the risk assessment of this patient for this surgery. (50%) How would you optimise this patient for surgery? (50%)
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A 45-year-old woman with a large anterior mediastinal mass is scheduled for mediastinoscopy and biopsy. Discuss your preoperative assessment of this patient.
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In a large clinical trial, patients were randomised into two groups to study the impact of using a nitrous oxide (N2O) anaesthetic on the incidence of death and other major cardiovascular events.The table below shows the results 70% N2O w 30% O2 Size 3500 Cases 283 Air in 30% O2 size 3500 number 296. Data analysis found that the difference in the incidence of death and major cardiovascular events had a p value of 0.64. The study reported that 70% N2O anaesthesia had a relative risk of death and major cardiovascular events of 0.96 (95% CI 0.82-1.13). Define the following terms and explain their meaning in relation to this study: P-value, Risk reduction, Confidence interval, Odds ratio
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Why is the radial artery a common site for arterial cannulation? What complications may occur from radial artery cannulation and how may they be minimised?
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Describe the management of a patient who has a total thyroidectomy and develops respiratory distress in the recovery room.
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