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Final clinical short case 42

Created: 24/4/2015
1. A patient with Down's syndrome and Eisenmenger's complex presents with sudden-onset painful pulseless foot.

- What is the likely diagnosis?
- Discuss the pathophysiology of Eisenmenger's complex.
- What are the management issues in theatre associated with Downs syndrome and Eisenmenger's complex?

2. A long-term smoker presents with a hoarse voice for direct laryngoscopy.

- What is the differential diagnosis?
- Discuss the preoperative assessment you would carry out.
- What are the airway and specific issues in this patient?
- How would you anaesthetise this patient?
- What might be the postoperative issues?

3. A long-term smoker presents with a lump on the right middle lobe of the lung on the chest X-ray.
- Present the chest X-ray findings.
- What are the possible differential diagnoses?
- Discuss the investigation of bronchial lumps.
- How would you anaesthetise for rigid bronchoscopy?
- How would you anaesthetise for lobectomy? (Discuss double-lumen tube issues).
- Discuss the physiology of one-lung ventilation (OLV)

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