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Final clinical short case 31

Created: 15/4/2011
1. A 4-year-old presents for squint surgery.
- What are the associated problems?
- Discuss the investigation of malignant hyperthermia
- How would you anaesthetise this child, including premedication?
- Discuss the treatment of the oculocardiac reflex and postoperative nausea and vomiting.

2. A patient is in the intensive care unit 48 hours post-arrest following a subarachnoid haemorrhage. He is still breathing.
- What would you do next?
- If the situation is unsalvageable, how would you explain this to the family?
- Discuss the issues surrounding withdrawal of care.
- Discuss the issues of living wills and the Mental Capacity Act.
- Discuss non-beating heart donation.

3. You are shown an ECG demonstrating left bundle branch block (LBBB) and first-degree heart block.
- What are the causes of LBBB?
- What symptoms are particularly worrying?
- Discuss the pathophysiology of LBBB.
- Would you anaesthetise this patient?

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