59 year old man for transurethral resection of the prostate
Ex-smoker, 20 cigarettes/day
Had 'shadow on lung' 2 years ago
Treated with radiotherapy and drugs - no further information available
Now coughing up blood
Drugs - glibenclamide 5 mg daily
BP: 150/90 mmHg
Respiratory rate: 20/min
- trachea deviated to right
- bronchial breathing and reduced breath sounds heard in the right upper chest
- 10 cm bladder palapable
||7.1 x 109/L|
||271 x 109/L|
Trachea deviated to right
Right upper zone shadowing and loss of volume on right
Lung function tests:
- Summarise the problems.
- Summarise the positive findings on examination.
- Does a BP of 150/90 mmHg bother you?
- Comment on the investigations.
- How would the raised urea and creatinine affect your management? (Give an example)
- What do you think of a blood glucose of 11 mmol/L?
- What does the CXR show and what is the differential diagnosis?
- Do the lung function tests show a restrictive picture?
- What else would you ask for regarding the lung function tests?
- Would you be happy to anaesthetise this patient now?
- What premedication would you prescribe and why?
- What is your management of his diabetes?
- What anaesthetic would you give and why?
- How would you perform spinal anaesthesia?