Essence of Anesthesia Practice

Thyroid Neoplasms

Risk Incidence in USA is 23,500 new thyroid cancer cases/y, but incidence is increasing. Account for approximately 1% of new cancer diagnoses each y. Hispanics, African Americans, lower rate; Caucasians, moderate rate; Japanese, Chinese, Hawaiian, Filipinos, higher rate. Overall incidence…

Thrombocytopenia

Risk Commonly present in pts with systemic illness (e.g., sepsis), pathologic conditions of pregnancy, and in pts requiring extracorporeal circulation. Prognosis is determined by underlying illness, not absolute platelet count. HIT, a prothrombotic immune-mediated disorder, occurs in <5% of pts…

Thalassemia

Risk Over 60,000 children are born annually with severe beta-thalassemia. Global regions that are primarily affected include the Mediterranean, North Africa, and Southeast Asia, where alpha thalassemia is more common. Beta-trait carrier status has a global prevalence of approximately 1.5%.…

Tetralogy of Fallot

Risk Occurs in 4-5:10,000 live births (1:2,000–2,500) Most common cyanotic CHD (10% of all CHDs) Occurs equally in males and females Perioperative Risks If unrepaired, tet spells can lead to RVH, RV failure, and death (50% in first year of…

Tetanus

Risk A major public health problem in the developing world, but improving; responsible for 200,000–300,000 deaths/y in 2000 and only 60,000 in 2013, and the vast majority were neonatal deaths. Incidence in USA: 0.16 cases/million population (1998–2000). Highest incidence in…

Takayasu Disease

Risk Worldwide incidence: 2.6 cases per million per y. Race with highest prevalence: Asian. Females 8–9 times more likely to be affected than males. Perioperative Risks Severe uncontrolled Htn leading to end-organ dysfunction Stenosis of major blood vessels affecting regional…

Systemic Lupus Erythematosus

Risk Prevalence: 1:2500 in Northern Europeans and 1:500 in African American population. Female:male ratio: 9:1. Peak age of onset is between 16-40 y; 20% of SLE pts present prior to age 16 y. Perioperative Risks Increased lupus activity is associated…

Syndrome X

Risk True incidence unknown Postmenopausal or posthysterectomy women most often at risk Common cause of chest pain in women with angiographically normal coronary arteries Linked to adverse cardiovascular outcomes and a poor quality of life No diagnostic test Perioperative Risks…

Syndrome of Inappropriate Antidiuretic Hormone Secretion

Risk Elderly pts Nursing home residents Planned major operations, especially neurosurgical procedures Pts receiving exogenous hormone therapy, especially desmopressin CNS disorders including psychiatric diseases Cancer, especially small-cell lung cancer Lung disease Perioperative Risks Hyponatremia Cerebral edema causing altered mentation, seizures,…

Swallowing Disorders

Risk Neuromuscular disorder or mechanical obstruction can cause difficulty in swallowing (dysphagia). Dysphagia can be classified into distinct types: Oropharyngeal dysphagia due to malfunction of the tongue, pharynx, larynx and/or upper esophageal sphincter and esophageal dysphagia due to malfunction of…