Search our site 
Advanced Search
Home | Exam dates | Contact us | About us | Testimonials |

You are in Home >> Exams >> Final FRCA >> Final FRCA SOE

Final clinical long case 50

Created: 25/10/2013
An elderly man presents on day 3 post-aortic abdominal aneurysm repair. He has primary malignant hypertension, type 2 diabetes mellitus, angina, chronic kidney disease and is a smoker. He is on spironolactone and Arthrotec but not antidiabetic medications. He is complaining of shortness of breath, palpitations and chest pain.

Full blood count: polycythaemia
Urea and electrolytes: mild renal impairment
Chest X-ray: hyper-expanded lungs, ?pulmonary oedema, ?right lower lobe consolidation, raised right hemidiaphragm, enlarged heart
ECG: irregular heart rate (100-150 bpm), ST depression and inverted T waves over various, but not all, regions.

1. What is going on in this case and why?
2. What could have been done to prevent it?
3. What treatment should be given?
4. Why do myocardial infarctions etc. typically occur at day 3 post-aortic abdominal aneurysm repair?
5. What would you do about the renal impairment?
6. What could have been done differently?
7. Which drugs should he be taking?
8. What renal protection can be employed at the time of the operation?
9. When would be the best time for this patient to receive haemofiltration?

SiteSection: Article
All comments (1)  Posting rules

     To view or add comments you must be a registered user and login  

Login Status  

You are not currently logged in.
UK/Ireland Registration
Overseas Registration

  Forgot your password?

All rights reserved © 2021. Designed by AnaesthesiaUK.

{Site map} {Site disclaimer} {Privacy Policy} {Terms and conditions}

 Like us on Facebook