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Final basic sciences short case 25

Created: 31/7/2013
1. Describe the anatomy of the spleen.
- What is its blood supply?
- What is its nerve supply?
- What are its functions?
- What are the indications for a splenectomy?
- How can you diagnose a ruptured spleen?

2. You have formally tested for and diagnosed a patient as brainstem dead.
- What are the physiological changes that occur after brainstem death?
- What are the exclusion criteria for organ transplantation?
- What criteria would have to be met for use of the donor’s lungs?
- How do you manage a brainstem-dead donor?
- What are the ethical issues regarding invasive procedures and supportive treatment?

3. What is TIVA?
- Describe the pharmacological model.
- What data do you put into the pump?
- What agents have you used?
- What doses are used for induction and maintenance?
- How does propofol differ from remifentanil with regard to TIVA?
- Draw a graph indicating context-sensitive half times for common agents.
- Draw a graph of how the plasma concentration and target site concentration change when you increase the required target site concentration on the pump.
- What are the disadvantages of TIVA?
- What steps do you take to minimise the risk of awareness?

4. List some SI units for electricity.
- Define an Ampere, a Joule and a Watt.
- What is the principle of electroconvulsive therapy (ECT)?
- What is it used for?
- What dose is normal, what are the units and for what duration is it applied?
- Why does an anaesthetist need to be present?
- Describe the physiological changes that occur.
- What are the contraindications?
- Describe your anaesthetic technique with doses of the agents that you use.
- Why do you use these agents at these doses?

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