Book contents
- Anesthesia Oral Board Review
- Anesthesia Oral Board Review
- Copyright page
- Contents
- Contributors
- Acknowledgments
- Letter from the Associate Editor
- How to Use This Book
- Format
- Applied Exam Tips for Success
- Part I General Information
- Part II Anesthetic-Related Critical Events and Information
- Section 1 Respiratory, Airway, and Ventilator Management
- Section 2 Cardiac, Thoracic, and Vascular Anesthesia
- Chapter 24 Hypotension
- Chapter 25 Hypertension
- Chapter 26 Arrhythmias
- Chapter 27 Cardiac Conduction Blocks
- Chapter 28 Acute Coronary Syndrome
- Chapter 29 Embolism
- Chapter 30 Cardiac Tamponade
- Chapter 31 Current ACC/AHA Guidelines for Peri-operative Cardiac Evaluation for a Noncardiac Surgery
- Chapter 32 Pacemaker/Implantable Cardioverter-Defibrillators (ICDs): Considerations for Anesthesiologists
- Chapter 33 Cardiac Valvular Abnormalities
- Chapter 34 Transcatheter Aortic Valve Replacement
- Chapter 35 Point of Care Ultrasound
- Chapter 36 Intra-operative Transesophageal Echocardiography
- Chapter 37 Cardiopulmonary Bypass (CPB) and Associated Anticoagulation
- Chapter 38 Carotid Surgery
- Chapter 39 Mediastinal Mass
- Section 3 Neuroanesthesia
- Section 4 Renal and Urological
- Section 5 Hepatic and Gastrointestinal
- Section 6 Obstetric Anesthesia
- Section 7 Pediatric Anesthesia
- Section 8 Endocrine
- Section 9 Trauma Anesthesia
- Section 10 Emergency Events
- Section 11 Organ Transplant
- Section 12 Post-Anesthesia Care Unit
- Section 13 Acute and Chronic Pain
- Section 14 Other Situations
- Section 15 Safety and Ethics
- Index
- References
Chapter 24 - Hypotension
from Section 2 - Cardiac, Thoracic, and Vascular Anesthesia
Published online by Cambridge University Press: 03 August 2023
- Anesthesia Oral Board Review
- Anesthesia Oral Board Review
- Copyright page
- Contents
- Contributors
- Acknowledgments
- Letter from the Associate Editor
- How to Use This Book
- Format
- Applied Exam Tips for Success
- Part I General Information
- Part II Anesthetic-Related Critical Events and Information
- Section 1 Respiratory, Airway, and Ventilator Management
- Section 2 Cardiac, Thoracic, and Vascular Anesthesia
- Chapter 24 Hypotension
- Chapter 25 Hypertension
- Chapter 26 Arrhythmias
- Chapter 27 Cardiac Conduction Blocks
- Chapter 28 Acute Coronary Syndrome
- Chapter 29 Embolism
- Chapter 30 Cardiac Tamponade
- Chapter 31 Current ACC/AHA Guidelines for Peri-operative Cardiac Evaluation for a Noncardiac Surgery
- Chapter 32 Pacemaker/Implantable Cardioverter-Defibrillators (ICDs): Considerations for Anesthesiologists
- Chapter 33 Cardiac Valvular Abnormalities
- Chapter 34 Transcatheter Aortic Valve Replacement
- Chapter 35 Point of Care Ultrasound
- Chapter 36 Intra-operative Transesophageal Echocardiography
- Chapter 37 Cardiopulmonary Bypass (CPB) and Associated Anticoagulation
- Chapter 38 Carotid Surgery
- Chapter 39 Mediastinal Mass
- Section 3 Neuroanesthesia
- Section 4 Renal and Urological
- Section 5 Hepatic and Gastrointestinal
- Section 6 Obstetric Anesthesia
- Section 7 Pediatric Anesthesia
- Section 8 Endocrine
- Section 9 Trauma Anesthesia
- Section 10 Emergency Events
- Section 11 Organ Transplant
- Section 12 Post-Anesthesia Care Unit
- Section 13 Acute and Chronic Pain
- Section 14 Other Situations
- Section 15 Safety and Ethics
- Index
- References
Summary
A 58-year-old female sustained a right femur fracture. She had a prior right total hip arthroplasty and will need a revision. Her past medical history includes hypertension, mild obstructive sleep apnea, hiatal hernia, and obesity. The patient is terrified of needles and states she had a bad experience with a prior cesarean section after multiple attempts at a spinal anesthetic. She is taken to the operating room and general anesthesia is induced with IV esmolol, lidocaine, fentanyl, propofol, and rocuronium. The tracheal intubation is uneventful. The femoral prosthesis with bone cement is placed. Two minutes later, you notice the end-tidal CO2 decrease to 25 mm Hg when it had been 35–40 mm Hg during the entire case. The minute ventilation has remained the same and you cycle the blood pressure cuff. The blood pressure is 78/45 mm Hg. A repeat blood pressure is 67/38 mm Hg and the end-tidal CO2 is now 12 mm Hg. What would you do next? What is your differential diagnosis?
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- Anesthesia Oral Board ReviewKnocking Out The Boards, pp. 89 - 92Publisher: Cambridge University PressPrint publication year: 2023