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Anesthesiology: A Problem-Based Learning Approach

Edited by Tracey Straker, Shobana Rajan, and Magdalena Anitescu

Through 51 case-based chapters, the book reviews current technology, drugs, surgical techniques, and anesthetic management for general anesthesiology
Evidence-based discussion and self-assessment questions included with each chapter
Uses a problem-based learning approach that is ideal for individual or group study
Includes online access to multiple choice questions with answers and explanations

Anesthesiology: A Problem-Based Learning Approach

Edited by Tracey Straker, Shobana Rajan, and Magdalena Anitescu

Description

Linking existing knowledge to new knowledge by presenting it in the form of a case or a problem is a popular and effective educational approach resulting in better retention of the knowledge and improved ability to apply that knowledge to solve real problems. This problem-based learning (PBL) method was introduced into medical education at McMaster University in Ontario, Canada, in 1969. Since then it has been widely incorporated into secondary, undergraduate, and graduate education in a variety of disciplines worldwide.

This new volume for the Anesthesiology Problem-Based Learning series reviews topics in general anesthesiology utilizing the PBL approach. Each chapter deals with conditions and problems in anesthesia practice presented as a case stem with questions to encourage critical thinking, followed by an evidence-based discussion and multiple-choice questions for self-assessment. Current in its knowledge of organ systems and management, the text keeps pace with new technology, new drugs, and new surgical techniques coupled with current guidelines for anesthetic management. Cases highlight the practical issues that arise in the operating room and offers solutions for them.

The book can be used to review an upcoming clinical case or as a PBL tool. The 'Stem Case' and 'Key Questions and Discussion' sections can serve as the basis for interactive learning experiences for study groups or as a broad yet in-depth clinical review of the specialty for the individual learner. Self-assessment questions can be used as a measure of knowledge acquisition or simply as a question bank to prepare for examinations.

Anesthesiology: A Problem-Based Learning Approach

Edited by Tracey Straker, Shobana Rajan, and Magdalena Anitescu

Preface
List of Contributors
Airway
Chapter 01: Management of the difficult airway in the MRI suite
Chapter 02: Hip Dislocation in a Patient with Scleroderma
Cardiac for the Generalist
Chapter 03: Atrial Fibrillation
Chapter 04: The LVAD Patient Presenting for Non-Cardiac Surgery
Chapter 05: Preoperative Chest Pain in a Patient with Colon Obstruction
Chapter 06: Perioperative anesthetic management of anterior mediastinal mass
Chapter 07: Gastric Ulcer Bleed - H/o Coronary artery disease, Hypertension, Hyperlipidemia
Chapter 8: Percutaneous Coronary Intervention (PCI) with Concomitant Atrial Fibrillation
Vascular
Chapter 9: Ruptured Abdominal Aortic Aneurysm- Open Abdominal Aortic Aneurysm Revisited
Chapter 10: LOWER EXTREMITY CLAUDICATION
Chapter 11: TEVAR - Thoracic Endovascular Surgery - Cerebral Spinal Fluid drainage catheters
Abdominal
Chapter 12: Active Pheochromacytoma
GI
Chapter 13: Pulmonary Co-morbidities in ERCP Procedure and Ambulatory Anesthesia
Plastics
Chapter 14: Anesthesia for Mastectomy with Autologous Flap
Orthopedics
Chapter 15: Anesthetic management for patients with severe cervical myelopathy
Chapter 16: A Patient with morbid obesity and OSA coming for shoulder arthroscopy
Genitourinary
Chapter 17: Robotic Prostatectomy
Chapter 18: End stage renal disease- Patient for kidney transplant
Blood Products
Chapter 19: Massive Transfusion
Chapter 20: Update on blood management in Liver transplant
Chapter 21: Acute Intraoperative Blood Loss in a Jehovah's Witness-Medical, Ethical and Legal Issues
Allergy
Chapter 22: Anaphylaxis in the OR - Causes, Recognition and Treatment
Transplant
Chapter 23: Anesthetic considerations in a Liver transplant recipient presenting for non-transplant surgery
Chapter 24: Patient with Liver Failure for Transjugular Intrahepatic Portosysytemic Shunt
PACU
Chapter 25: Waking Up My Outpatient, Who Looks to Now Be Seizing. What to do next in PACU?
Chapter 26: Obstructive Sleep Apnea: Peri-Anesthetic Concerns and Management
Chapter 27: Rheumatoid Arthritis Patient Coming For a Total Knee Replacement
Obstetrics
Chapter 28: Anesthesia in a Pregnant Patient coming for urgent non-obstetric surgery
Chapter 29: Preeclampsia Problem Based Learning Discussion
Chapter 30: Pregnancy Management in a Parturient with Tetralogy of Fallot
Renal
Chapter 31: Intraoperative Hyperkalemia
Endocrine
Chapter 32: Diabetic Ketoacidosis (DKA) Management
Chapter 33: Myasthenia gravis patient coming for ureteroscopy
Chapter 34: Patient with a Large Goiter for Thyroid Surgery
Hematology
Chapter 35: Sickle Cell Disease and Cholecystectomy
Chapter 36: Anesthesia in a patient on anticoagulant - dabigatran coming for emergency surgery
ENT
Chapter 37: Tracheal Stenosis
Chapter 38: Methemoglobinemia
Chapter 39: Anesthesia for Functional Endoscopic Sinus Surgery
Chapter 40: Anesthetic management of a patient with Multiple Laryngeal Papillomatosis
Chapter 41: Anesthetic management of the patient with retropharyngeal abscess with emphasis on the perioperative and airway management
Ambulatory
Chapter 42: Anesthesia for Carpal Tunnel Surgery
Bariatric anesthesia
Chapter 43: Peri-operative Care of the Bariatric Surgery Patient
Miscellaneous
Chapter 44: Anesthetic considerations in patients with automatic implantable cardio defibrillator presenting for non-cardiac surgery.
Chapter 45: Anesthetic Considerations in Autonomic Hypereflexia
Chapter 46: NPO Guidelines
Chapter 47: Severe COPD patient coming for retinal detachment surgery
Practice Management Issues
Chapter 48: Utilization of Practice Improvement Methodologies to Enhance the OR efficiency
Chapter 49: Operating Room Fire
Chapter 50: Intraoperative Awareness
Chapter 51: Post-Operative Cognitive Dysfunction (POCD)
Index

Anesthesiology: A Problem-Based Learning Approach

Edited by Tracey Straker, Shobana Rajan, and Magdalena Anitescu

Author Information

Edited by Tracey Straker, Associate Professor of Clinical Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Shobana Rajan, Associate Staff Anesthesiologist, The Cleveland Clinic, and Magdalena Anitescu, Associate Professor of Anesthesiology, University of Chicago

Tracey Straker, MD MS MPH FASA Professor Anesthesiology Director General Anesthesia Director of Advanced Airway Fellowship and Rotation Department of Anesthesiology Montefiore Medical Center The University Hospital for Albert Einstein College of Medicine Bronx, New York Shobana Rajan, MD Assistant Professor and Staff Anesthesiologist, General Anesthesiology Associate Program Director, Neuroanesthesia Fellowship Assistant Director, PACU Cleveland Clinic, Cleveland, Ohio

Contributors:

Ali R Abdullah, MD
Anesthesiologist
Department of Anesthesiology and Critical Care Medicine
Allegheny Healthy Network
Allegheny General Hospital
Pittsburgh, PA

A.Elisabeth Abramowicz, MD
Associate Professor of Clinical Anesthesiology
New York Medical College
Valhalla, NY

John N. Afthinos, M.D., F.A.C.S.
Surgeon
Department of Surgery
Northwell Health
Forest Hills, NY

Melinda Aquino, M.D.
Assistant Professor
Anesthesiology, Pain Management and Regional Anesthesiology
Albert Einstein College of Medicine
Montefiore Medical Center
Bronx, NY

Maged Argalious, MD, MSc, MBA, MEd, FASE
Professor of Anesthesiology
CCLCM Program Director
Anesthesiology Residency
Cleveland Clinic
Anesthesiology Institute
Vice Chair of Education
Anesthesiology Institute
Cleveland, OH

Valerie Armstead, M.D.
Professor
Lewis Katz School of Medicine
Temple University
Philadelphia, PA

Lovkesh Arora, MBBS, MD
Clinical Assistant Professor
Roy J and Lucille A Carver College of Medicine
University of Iowa
Iowa City, IA

Theresa J. Barnes, MD, MPH
Department of General Anesthesia
Cleveland Clinic
Cleveland, OH

Alexandra Bastien, MD
Assistant Professor
Department of Anesthesiology
Albert Einstein College of Medicine
Montefiore Medical Center
Bronx, NY

Amanda Moraska Benson, MD
Staff Anesthesiologist and Intensivist
Surgical Intensive Care Unit
Center for Critical Care
Cleveland Clinic
Cleveland, OH

Jay Berger, MD
Assistant Professor
Department of Anesthesiology
Montefiore Medical Center
Bronx, NY

Shobana Bharadwaj, MD
Program Director
Obstetric Anesthesiology Fellowship
Interim Obstetric Division Chief
University of Maryland Medical Center
Baltimore, MD

Jessica Galey, MD
Assistant Professor
University of Maryland School of Medicine
Baltimore, MD

Nichelle Broderick, MD
Anesthesiologist Resident
Montefiore Medical Center
Bronx, NY

John Cagino, MD
Anesthesiologist
Albany Medical Center
Albany, NY

Terry Ann Chambers, MD
Assistant Professor
Department of Anesthesiology
Albert Einstein College of Medicine
Montefiore Medical Center
Bronx, NY

Shobana Chandrasekhar, MD
Department of Anesthesiology
Baylor College of Medicine
Houston, TX

Curtis Choice, MD MS
Montefiore Medical Center
The University Hospital for Albert Einstein School of Medicine
Bronx, NY

Miguel A. Cruz, M.D.
Medical Director of PACU
General Anesthesiology
Cleveland Clinic
Cleveland, OH

Guensley Delva, MD
CA-2 Resident
Anesthesiology
Montefiore Medical Center
Bronx, NY

Yi Deng, MD
Department of Anesthesiology
Baylor College of Medicine
Assistant Professor of Cardiothoracic Anesthesiology and critical Care Medicine
Associate Director of Cardiothoracic Anesthesiology at Ben Taub Hospital
Baylor College of Medicine
Houston, TX

Jagan Devarajan, MD
Staff Anesthesiologist
Cleveland Clinic
Cleveland, OH

Rachel Diehl, MD
Chief Resident
Anesthesiology Institute
Cleveland Clinic
Cleveland, OH

Ehab Farag, MD, FRCA
Associate Professor
Staff Anesthesiologist
Department of General Anesthesiology and Outcomes Research
Cleveland Clinic
Cleveland, OH

Komal Gandhi, MD
Assistant Professor
Department of Anaesthesia and Intensive Care
Post-Graduate Institute of Medical Education and Research
Chandigarh, India

Lindsay Gennari, MD
Assistant Professor
Albany Medical Center
Albany, NY

Karen E. Gibbs, M.D., F.A.C.S.
Division of Minimally Invasive and Bariatric Surgery
Department of Surgery
Staten Island University Hospital
Northwell Health
Staten Island, NY

Cheryl Gooden, MD
Anesthesiologist
Bronx-Care Health System
Bronx-Lebanon Hospital
Bronx, NY

Radhika P Grandhe, MD
Assistant Professor
Department of Anesthesiology
University of New Mexico
Albuquerque, NM

Ferenc Gyulai, MD
Professor of Anesthesiology
Vice Chair
Department of Anesthesiology and Perioperative Medicine
University of Missouri
Columbia, MO

Vilma Joseph, MD MPH FASA
Associate Professor of Clinical Anesthesiology, AECOM
Department of Anesthesiology
Montefiore Medical Center
Bronx, NY

Indu Kapoor, MD
Assistant Professor, Neuro Anesthesiology
All India Institute of Medical Sciences
Ansari Nagar, New Delhi

Myrna Kcomt, MD
Anesthesiologist
Department of Anesthesiology
Montefiore Medical Center
Bronx, NY

Sean P Kelly, MD
Resident
Department of Anesthesiology
University of New Mexico
Albuquerque, NM

Sandeep Khanna, MD
Staff Anesthesiologist
Cleveland Clinic
Associate Program Director
Cleveland Clinic Foundation
Anesthesiology Residency
Anesthesiology Institute
Clinical Assistant Professor
Lerner College of Medicine
Cleveland, OH

Ashish K. Khanna, MD, FCCP
Staff Anesthesiologist and Intensivist
Surgical Intensive Care Unit
Center for Critical Care
Department of Outcomes Research
Cleveland Clinic
Cleveland, OH

Sung Kim, MD
University of Iowa
Roy J and Lucille A Carver College of Medicine
Iowa City, IA

Jennifer Knuth, MD
Assistant Professor
Department of Anesthesiology
Albany Medical Center
Albany, NY

Sree Kolli, MD
Cleveland Clinic
Anesthesiology Institute
Cleveland, OH

Perin Kothari, DO
Chief Resident
Anesthesiology Institute
Cleveland Clinic
Cleveland, OH

Oran Kremen, MD
Anesthesiologist
North Shore University Hospital
Manhasset, NY

Kumar Vivek, MD
Anesthesiologist
Montefiore Medical Center
Bronx, NY

Dustin Liebling, MD
Anesthesiology Resident
Monte Fiore Medical Center
Bronx, NY

Charu Mahajan, MD
Assistant Professor, Neuro Anesthesiology
All India Institute of Medical Sciences
Ansari Nagar, New Delhi

Mazen A Maktabi, MBBCH
Associate Professor
Department of Anesthesia Critical Care and Pain Medicine
Massachusetts General Hospital
Harvard Medical School
Boston MA

Glenn Mann, MD
Assistant Professor of Anesthesiology, AECOM
Department of Anesthesiology
Montefiore Medical Center
Bronx, NY

Marina Moguilevitch, MD
Director, Division of Transplant Anesthesia
Department of Anesthesiology
Montefiore Medical Center
Bronx, NY

Iyabo Muse, MD
Assistant Professor
Regional Anesthesiologist
Department of Anesthesiology
Montefiore Medical Center
Hospital of Albert Einstein Medical School
Bronx, NY

Eman Nada MD, PhD
Assistant Professor
Department of Anesthesiology and Perioperative Medicine
University of Massachusetts
Worcester, MA

Chukwuemek Okafor, MD
Resident
Anesthesiology
Montefiore Medical Center
Bronx, NY

Nidhi Panda, MD
Professor, Department of Anaesthesia and Intensive Care
Post-Graduate Institute of Medical Education and Research
Chandigarh, India

Roshan Patel, MD
Assistant Professor
Department of Anesthesiology
Albert Einstein College of Medicine
Bronx, NY

Thomas Powell, MD
Department of Anesthesiology
Baylor College of Medicine
Houston, TX

Hemanshu Prabhakar, MD
Professor, Department of Neuroanaesthesiology and Critical Care
All India Institute of Medical Sciences
New Delhi, India

Shilpa Rao, MD
Assistant Professor of Anesthesiology
Department of Anesthesiology
Yale New Haven Hospital
Yale School of Medicine
New Haven, CT

Shamantha Reddy, MD
Assistant Professor of Anesthesiology
Department of Anesthesiology
Montefiore Medical Center / Albert Einstein College of Medicine
Bronx, NY

Nii Amon Robertson, MD
Resident
Department of Anesthesiology
Montefiore Medical Center
Hospital of Albert Einstein Medical School
Bronx, NY

Kurt Ruetzler, MD
Staff Anesthesiologist
Anesthesiology Institute
Department of Outcomes Research
Cleveland Clinic Foundation
Cleveland, OH

Wael Saasouh, MD
Neuroanesthesiology fellow
Department of General Anesthesiology
Cleveland Clinic
Cleveland, OH

Irim Salik, MD
Anesthesiologist
Westchester Medical Center
Valhalla, NY

Surangama Sharma, MBBS, MD
Clinical Assistant Professor
Roy J and Lucille A Carver College of Medicine
University of Iowa
Iowa City, IA

Surangama Sharma, MBBS, MD
Clinical Assistant Professor
Roy J and Lucille A Carver College Medicine
University of Iowa
Iowa City, IA

Christopher Sheerer, DO
Anesthesiology Resident
Anesthesiology Institute
Cleveland Clinic Foundation
Cleveland, OH

Yelena Spitzer, MD

Assistant Professor of Anesthesiology
Department of Anesthesiology
Montefiore Medical Center / Albert Einstein College of Medicine
Bronx, NY

Roshni Sreedharan, M.D
Assistant Professor of Anesthesiology
Cleveland Clinic Lerner College of Medicine
Staff Anesthesiologist and Intensivist
Department of General Anesthesiology and Center for Critical Care
Cleveland, OH

Christopher Y. Tanaka, M.D.
Attending Anesthesiologist
Assistant Professor of Anesthesiology
Montefiore Medical Center/Albert Einstein College of Medicine
Department of Anesthesiology
Bronx, NY

Edwin Tavarez, MD
Assistant Professor of Anesthesiology, AECOM
Department of Anesthesiology
Montefiore Medical Center
Bronx, NY

Michael Ting, MD
Anesthesiologist
Cleveland Clinic Foundation
Cleveland, OH

Mark Teen, MD
Pediatric Anesthesiology fellow
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

Elizabeth M. Vue, M.D.
Anesthesiology Resident
Department of Anesthesiology
Montefiore Medical Center, Albert Einstein College of Medicine
Bronx, NY

Michael Jon Williams, M.D.
Anesthesiologist
Thomas Jefferson University Hospital
Philadelphia, PA

Lisa Mouzi Wofford, MD
Department of Anesthesiology
Baylor College of Medicine
Houston, TX

Lu Zheng, MD
Department of Anesthesiology and Critical Care Medicine
Allegheny Healthy Network
Allegheny General Hospital
Pittsburgh, PA