Case Synopsis A 23-year-old man arrives in the emergency department with a gunshot wound to the right upper quadrant of the abdomen. He is combative and confused. His vital signs include systolic blood pressure, 70 mm Hg; heart rate, 119…
Case Synopsis An otherwise healthy 70-year-old man undergoes combined transurethral resection of the prostate (TURP) and transurethral resection of a bladder tumor (TURBT) under spinal anesthesia with sedation. His blood pressure is 130/90 mm Hg, heart rate is 68 beats…
Case Synopsis 1 A 55-year-old woman with a 5-year history of swelling in the front of the neck presented for subtotal thyroidectomy. She has a history of palpitations on minimal exertion. She gives a history of shortness of breath on…
Case Synopsis A 78-year-old man with morbid obesity (body mass index [BMI] 43), chronic atrial fibrillation on dabigatran (discontinued 5 days prior), and metastatic renal cell carcinoma to T8 is undergoing corpectomy and multilevel instrumented fusion using propofol-based total intravenous…
Case Synopsis A 44-year-old man with treated hypertension and an extensive smoking history presents with malaise, weight loss, and painless hematuria. Computed tomography (CT) reveals a right-sided renal tumor with thrombus extending into the right renal vein and minimal extension…
Case Synopsis A 50-year-old man presents to the emergency department after falling from the roof of his house. He is tachycardic (heart rate of 120 beats per minute) and normotensive (blood pressure of 130/88 mm Hg), with a grossly distended…
Case Synopsis A 78-year-old woman with a history of severe coronary artery disease underwent extracorporeal shock wave lithotripsy with general anesthesia. Ten minutes after placement in the water bath, the patient’s heart rate increased from 78 to 138 beats per…
Case Synopsis A 75-year-old man with dyslipidemia and hypertension is scheduled for elective laparoscopic repair of hiatal hernia. He has been on nothing-by-mouth (NPO; from the Latin, nil per os ) status for 12 hours except for his antihypertensive medications…
Case Synopsis A 55-year-old man is scheduled for emergency exploratory laparotomy for small bowel obstruction. Anesthesia is induced with intravenous (IV) fentanyl, lidocaine, propofol, and succinylcholine and maintained with sevoflurane in an air-oxygen mixture with vecuronium. During the surgery the…
Case Synopsis 1 Pheochromocytoma A 38-year-old woman presents in the surgical outpatient department with recurrent attacks of palpitations, headache, diaphoresis, occasional right-sided abdominal pain over the last year, and a neck swelling for the last 2 months. On examination she…