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Yao & Artusio's Anesthesiology: Problem-Oriented Patient Management
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Dantrium
C.6. Twenty minutes into the procedure with sevoflurane anesthesia, the patient develops increasing tachycardia with ventricular premature beats and mottled skin. What emergency measures should you take?
Malignant Hyperthermia
C.9. How does the new formulation of dantrolene (Ryanodex) compare with the previous formulations of dantrolene (Dantrium or Revonto)?
Dapsone
Daunorubicin
B.19. If the patient is a 90-year-old with an order of Do-Not-Resuscitate (DNR), how would you discuss the management of a perioperative DNR order with the patient and family?
Asthma and Chronic Obstructive Pulmonary Disease
DDAVP
A.5. What are the principles of perioperative donor management?
A.3. What is the treatment for a patient with von Willebrand disease?
B.6. Should this patient be transfused with fresh frozen plasma (FFP) prior to surgery?
Demerol
Desmopressin
A.5. What are the principles of perioperative donor management?
A.3. What is the treatment for a patient with von Willebrand disease?
B.6. Should this patient be transfused with fresh frozen plasma (FFP) prior to surgery?
Dexamethasone
Dextromethorphan
Dextrose in water
C.4. Why are hypertonic fluids used during a craniotomy?
A.5. What electrolyte imbalances occur in patients with impaired renal function, and how are they treated?
C.II-14. How do you prepare an intravenous (IV) infusion of sodium nitroprusside, nicardipine, and nitroglycerin? What are the usual doses? Which do you prefer to use?
Dextrose
Diazepam
B.1. What aspects of the patient's history and physical exam are most important in formulating your anesthetic plan?
B.3. How are routine medications and immunosuppressive medications managed in the perioperative period?
B.6. What drug therapy is the treatment of choice for seizure prophylaxis?
C.3. How does the liver disease affect intraoperative medication management?
C.8. What are the effects of ketamine on the eye?
Myasthenia Gravis
A.2. What are the nonsurgical treatment options for back pain?
B.11. Discuss the management of eclampsia.
B.6. The surgery was postponed for 6 weeks. The patient presents for surgery again, currently on a regimen of metoprolol, aspirin, atorvastatin, captopril, hydrochlorothiazide, and potassium chloride. Their BP is 160/60 mm Hg and potassium 4.0 mEq/L. Would you premedicate this patient?
C.15. What therapeutic measures are recommended for patients with TURP syndrome?
C.3. How do you treat systemic toxicity of local anesthetic drugs?
Major and Complex Spine Surgery
Dibucaine
A.5. If succinylcholine were the only NMBA used during the case and the patient did not exhibit a response to TOF stimulation, what is the likely diagnosis? How would you confirm it?
A.6. What are acetylcholinesterase and plasma cholinesterase? What is the clinical significance of heterozygosity for atypical pseudocholinesterase (PChE)?
Didanosine
A.6. How many modes of pacing are available in modern PPMs? How do they work? What is the difference between DDD pacing and DDI pacing?
Cardiac Implantable Electronic Devices
Dideoxyinosine
A.6. How many modes of pacing are available in modern PPMs? How do they work? What is the difference between DDD pacing and DDI pacing?
Cardiac Implantable Electronic Devices
Diethylstilbestrol
A.3. What is percutaneous coronary intervention (PCI)? Discuss its indications, contraindications, and results.
A.7. Based on his history, would you recommend that this patient's surgery be postponed for a certain period? If so, why?
B.4. What types of coronary stents are available? What is their perioperative relevance?
B.5. What is the conventional recommendation for dual antiplatelet therapy (DAPT) in a patient with previous percutaneous coronary intervention (PCI) undergoing elective noncardiac surgery?
Ischemic Heart Disease and Noncardiac Surgery
A.5. What are the risk factors for perioperative myocardial infarction (MI) in patients with ischemic heart disease? What can be done to reduce the risk of ischemic events in these patients?
B.2. What is the role of cardiac stress testing and noninvasive coronary imaging for this patient?
B.5. How should this patient's antiplatelet therapy be managed perioperatively?
B.7. How should patients with coronary stents undergoing noncardiac surgery be managed?
Transurethral Resection of the Prostate and Geriatric Anesthesia
Digoxin
A.19. If mitral stenosis is first recognized during pregnancy and symptoms develop, how would you treat the patient?
B.4. Should hypokalemia be treated before anesthesia? Why?
B.7. How would you optimize the preoperative treatment of HF?
C.9. Would this patient benefit from the use of -blockers?
A.8. Would you give digitalis to treat congestive heart failure in preterm infants? Why?
B.4. What preoperative laboratory testing is necessary for surgical outpatients?
C.1. What are some of the anesthetic options for this patient?
Diltiazem
A.14. What is the mechanism of action of the major antihypertensive drugs?
C.10. During the surgery, the blood pressure increases to 220/120 mm Hg. How would you treat the hypertension?
C.11. When would you extubate the trachea in this patient? What could you do to prevent hypertension and tachycardia during extubation and emergence?
C.6. Twenty minutes into the procedure with sevoflurane anesthesia, the patient develops increasing tachycardia with ventricular premature beats and mottled skin. What emergency measures should you take?
A.6. Which perioperative medical therapies would you employ to reduce the incidence of myocardial ischemia?
C.11. What could you do to prevent hypertension during tracheal extubation and emergence?
C.3. By what means would you attempt to maximize hemodynamic stability?
C.II-14. How do you prepare an intravenous (IV) infusion of sodium nitroprusside, nicardipine, and nitroglycerin? What are the usual doses? Which do you prefer to use?
E.11. What are the significant implications of posttransplant hypertension?
D.1. The patient developed hypertension, BP 210/110 mm Hg, in the postanesthesia care unit. What would you do?
Daclizumab
Dantrolene
Dexmedetomidine
Dibenzyline
Dilaudid
Dinoprostone
A.6. What are the potential sources of pain in the spine?
A.9. How is ductal patency maintained?
A.9. How does indomethacin help in the closure of the ductus? What are the adverse effects of indomethacin? What are other pharmacologic options?
C.6. After delivery of the placenta in a cesarean delivery, what maneuvers and drugs can enhance myometrial contractility and therefore decrease blood loss?
Diphenhydramine
A.2. What are the normal physiologic consequences of aging for the various organ systems?
B.2. Would you premedicate this patient? If so, how?
C.12. What is the differential diagnosis of intraoperative bronchospasm?
A.3. How should drug dosages be adjusted for older patients? Should any particular medications be avoided?
B.3. How are routine medications and immunosuppressive medications managed in the perioperative period?
D.5. What are the mechanisms and risk factors for POCD? How would you mitigate the risk of POCD? Does the anesthetic technique influence the development of POCD?
Diphtheria and tetanus toxoids, adsorbed
Dipyridamole
B.2. What is the significance of the preoperative ECG? Would you wish to pursue a preoperative cardiac workup? What tests would you request, and what would they tell you?
B.2. What is the role of cardiac stress testing and noninvasive coronary imaging for this patient?
Docusate
A.1. What is the problem of concern in this case?
C.1. How would you monitor this patient?
B.4. What is the role of enhanced recovery after surgery (ERAS) in bariatric surgery? How does the public find a quality bariatric surgery team and surgical facility? What is the role of robotics in bariatric surgery?
D.5. How long would you prescribe supplementary oxygen postoperatively?
Dolophine
Doxacurium
Doxazosin
B.2. How do you pharmacologically prepare the patient with a pheochromocytoma for surgery?
A.14. What is the mechanism of action of the major antihypertensive drugs?
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