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Oral case 14

Created: 6/9/2004

Obstetrics- anesthesia during the first trimester

A 28-year old woman who is 10 weeks pregnant requires anesthesia for repair of a tri-malleolar fracture of the ankle. She is concerned about drugs and birth defects.

1. What will you tell her?

2. Will you recommend regional or general anesthesia? Explain.

3. If she had acute cholecystitis instead, what kind of anesthesia would you recommend?

Renal disease and emergency surgery

A patient with end stage renal disease required emergency laparotomy for a ruptured appendix. The potassium is 6.8 mEq/l.

1. Must this potassium be lowered preoperatively? Why or why not?

2. How would you lower the potassium?

3. Would you use succinylcholine for a rapid sequence induction?

4. What relaxant would you use? Explain.

Airway management- vocal cord surgery

1. How would you manage the airway in an adult requiring laser excision of vocal cord papillomas?

2. Would you use an endotracheal tube?

3. Would you use spontaneous or controlled ventilation?

4. How would you manage postoperative dyspnea and stridor?

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