Essence of Anesthesia Practice

Wilson Disease

Risk Incidence: 1:30,000. Slightly more common among Eastern European Jewish populations. Children and young adults tend to present with nonspecific GI symptoms. Adults tend to present with neurologic symptoms. Perioperative Risks Increased risk of liver failure, kidney failure, and cardiac…

Wilms Tumor

Risk Most common malignant renal tumor in childhood. Accounts for 6% of all childhood malignancies. 5-7.8 cases per million children <15 y old in the USA. Prevalence: Males equal to females. Peak age is 1–3 y. 5% bilateral. Relapse-free survival…

Wegener Granulomatosis (Granulomatosis With Polyangiitis)

Risk Prevalence of 3:100,000 persons affected More common in the white race; however, no gender affinity Respiratory failure Upper airway compromise Cardiovascular instability Acute renal failure Peripheral neuropathy Bleeding disorder Perioperative Risks Medication toxicity, side effects, and interactions Systemic involvement,…

Waldenström Macroglobulinemia

Risk Rare hematologic neoplasm (accounts for 1–2% of hematologic malignancies). In USA, age-adjusted incidence of 5.7 per million among males and 2.7 per million among females. Median age at diagnosis is 73 y. Racial preponderance: Whites >African Americans (4.1 vs.…

Von Willebrand Disease

Risk Most common inherited bleeding disorder. >1 million people within USA; 1% carry the gene (severe disease 1:10,000-1,000,000). No race/gender with highest prevalence. Perioperative Risks Significant risk of bleeding if untreated Increased risk if hepatic dysfunction present Worry About Excessive…

Von Hippel-Lindau Disease

Risk Rare; approximate incidence is 1:36,000. Usually occurs in young adults with complex multiple manifestations. Perioperative Risks Pts with cerebral hemangioblastoma have a 23% incidence of VHLD; assess other systems carefully. Worry About Space-occupying central nervous tumors (retinal and cerebellar…

Vitamin K Deficiency

Risk Vitamin K deficiency bleeding (VKDB) from abnormal factors II, VII, IX, and X. Controversy exists regarding whether vitamin K deficiency leads to osteoporosis, abnormal cartilage calcification, and possible arterial calcification resulting in CV disease. Perioperative Risks Minor or massive…

Vitamin D Deficiency

Risk High prevalence of deficiency (much more than previously recognized). At risk: Dietary insufficiency, breastfed infants, inadequate sun exposure, elderly, nursing home residents, institutionalized, dark skinned individuals, obese, post gastric bypass, IBD. Genetically predisposed: Rickets, osteomalacia. Worry About Hypocalcemia; vitamin…

Vitamin B 12 /Folate Deficiency

Risk 5–10% of adults over the age of 65 have vitamin B 12 or folate deficiency. Vitamin B 12 (cobalamin) deficiency is associated with a strict vegan diet, pernicious anemia, gastrectomy procedures, exposure to nitrous oxide, HIV infection, H. pylori…

Ventricular Tachycardia

Risk Structural heart disease (most commonly a chronic phase of MI); predictor of sudden cardiac death after MI. Most common cause of mortality with CHF. Cardiomyopathies, both hypertrophic and dilated, are assoc with VTach. Seen in genetic syndromes such as…