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Primary Viva 8 (Clinical)

Created: 14/9/2004

1. You are invited to anaesthetise a 60-year-old female for a retinal detachment. She has had asthma for many years and takes inhaled steroids.

– How would you assess her, as regards her asthma? (Her history includes taking oral steroids; on examination, she has pulsus paradoxus)

– What would you use to provide analgesia for her preoperatively?

– How would you anaesthetise her? Discuss the effects of the drugs you mention on this patient’s asthma.

– What would you consider to be essential monitoring in the operating theatre?
– During anaesthesia, an 'astute medical student' draws your attention to the fact that the end-tidal CO2 has risen to 12 kPa. What would you do?

2. You are presented with a young female primip of 38–40 weeks’ gestation, who is to have a Caesarean section.

– What issues would you address in your preoperative assessment?

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