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Primary Viva 18 (Clinical)

Created: 27/6/2006
Updated: 27/6/2006
1. A 41-year-old patient presents with menorrhagia for hysterectomy. The patient is otherwise healthy.
– Would you accept this patient for surgery?
– Would you transfuse blood preoperatively? 
– What are the problems associated with a blood transfusion?
– When is a transfusion indicated?
– What are the physiological changes associated with anaemia?
–At what haemoglobin level would you transfuse?
– Discuss the management of this patient; how would you prepare this patient for surgery?
– Which type of anaesthetic would you choose: spinal or general?
– What procedures would you undertake intraoperatively?
– What might be your concerns postoperatively?
– What analgesia would you administer?

2. Critical incident: You are anaesthetizing the above patient for her hysterectomy, and there is blood loss, so you begin a transfusion. Shortly thereafter, your operating department assistant informs you that there was an error in the blood crossmatch.
– What would you do?

3. A patient presents with latex allergy.
- Describe your treatment plan.
4. A patient presents with acromegaly.
- How would you treat them?
5. An ECG reveals a patient to have anterior ischaemia.
- What would you do next?

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