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Anaesthesiology

Rare Coexisting Diseases

Built from Barash Clinical Anesthesia, 9th Edition

What’s inside

8 sections · 194 slides

  1. 01

    Overview

    • Disease groups covered
    • Recurring perioperative themes

    2 slides

  2. 02

    Musculoskeletal Diseases

    • Muscular dystrophy: definition and basis
    • Muscle cell cytoskeleton
    • Types of muscular dystrophy and congenital myopathies
    • Types of muscular dystrophy and congenital myopathies (continued)
    • Pattern of muscle weakness in the muscular dystrophies
    • Duchenne muscular dystrophy
    • Emery-Dreifuss and limb-girdle muscular dystrophy
    • Congenital muscular dystrophy and congenital myopathy
    • Anesthetic management of muscular dystrophy
    • Suxamethonium and volatile agents in muscular dystrophy
    • Hyperkalaemic cardiac arrest after suxamethonium
    • Myotonic dystrophy: definition
    • Classification of myotonic dystrophy
    • Myotonic dystrophy type 1
    • Cardiac disease in myotonic dystrophy type 1
    • Anesthetic management of myotonic dystrophy
    • Skeletal muscle channelopathies
    • Skeletal muscle channelopathies
    • Hyperkalaemic periodic paralysis
    • Clinical features of familial periodic paralysis
    • Clinical features of familial periodic paralysis (continued)
    • Anesthetic management of the channelopathies
    • Relaxants and malignant hyperthermia risk in channelopathies
    • Myasthenia gravis: definition and epidemiology
    • Clinical features of myasthenia gravis
    • Clinical presentations of myasthenia gravis
    • Myasthenia Gravis Foundation of America clinical classification
    • Myasthenia Gravis Foundation of America clinical classification (continued)
    • Anesthetic concerns in myasthenia gravis
    • Dose-response for vecuronium in myasthenia gravis
    • Choice of technique in myasthenia gravis
    • Predictors of postoperative ventilation and extubation criteria
    • Myasthenic syndrome: definition
    • Comparison of myasthenic syndrome and myasthenia gravis
    • Distinguishing myasthenic syndrome from myasthenia gravis
    • Guillain-Barre syndrome: definition
    • Anesthetic management of Guillain-Barre syndrome

    37 slides

  3. 03

    Central Nervous System Disease

    • Multiple sclerosis: definition and mechanism
    • Anesthesia and the course of multiple sclerosis
    • Epilepsy: definition
    • Grand mal, focal cortical and absence seizures
    • Antiepileptic drug therapy
    • Antiepileptic drugs classified by mechanism of action
    • Antiepileptic drugs classified by mechanism of action (continued)
    • Antiepileptic drugs classified by mechanism of action (continued)
    • Anesthetic management in epilepsy
    • The amyloid cascade in Alzheimer disease
    • Anesthesia and postoperative cognitive dysfunction
    • Anesthetic technique in Alzheimer disease
    • Parkinson disease: cause and clinical signs
    • Drug treatment of Parkinson disease
    • Preoperative dopaminergic therapy in Parkinson disease
    • Intraoperative management of Parkinson disease
    • Huntington disease: genetics and pathology
    • Anesthetic management of Huntington disease
    • Amyotrophic lateral sclerosis: mechanism
    • Clinical presentation of amyotrophic lateral sclerosis
    • Anesthetic management of amyotrophic lateral sclerosis
    • Creutzfeldt-Jakob disease: the prion
    • Anesthetic precautions in Creutzfeldt-Jakob disease

    23 slides

  4. 04

    Other Inherited Disorders

    • Malignant hyperthermia: definition
    • Mechanism of malignant hyperthermia
    • Excitation-contraction coupling and malignant hyperthermia
    • Early signs of a malignant hyperthermia episode
    • Malignant hyperthermia clinical grading scale
    • Malignant hyperthermia clinical grading scale (continued)
    • Malignant hyperthermia clinical grading scale (continued)
    • Immediate response to a malignant hyperthermia crisis
    • Dantrolene in malignant hyperthermia
    • Treatment of an acute episode of malignant hyperthermia
    • Treatment of an acute episode of malignant hyperthermia (continued)
    • Preparing for the susceptible patient
    • Safe versus unsafe drugs in malignant hyperthermia
    • Safe versus unsafe drugs in malignant hyperthermia (continued)
    • Porphyrias: definition
    • Classification of the porphyrias
    • Classification of porphyrias
    • Classification of porphyrias (continued)
    • Features of an acute porphyric crisis
    • Presentation of an acute crisis of acute porphyria
    • Presentation of an acute crisis of acute porphyria (continued)
    • Presentation of an acute crisis of acute porphyria (continued)
    • Drug safety in porphyria
    • Pseudocholinesterase: what it does
    • Clinical consequence of pseudocholinesterase deficiency
    • Dibucaine number
    • Interpreting the dibucaine number
    • Classic cholinesterase genotypes
    • Anesthetic management of cholinesterase deficiency
    • Glycogen storage diseases: definition
    • Three critical consequences of glycogen storage disease
    • Pathway of glycogen synthesis and degradation
    • Classification of glycogen storage diseases
    • Classification of glycogen storage diseases, continued
    • Type I: Von Gierke disease
    • Anesthetic management of Von Gierke disease
    • Type II: Pompe disease
    • Anesthetic risk in infantile Pompe disease
    • Anesthetic concerns in type III glycogen storage disease
    • Type V: McArdle disease
    • Anesthetic management of McArdle disease
    • Types VI, VII and IX glycogen storage disease
    • Mucopolysaccharidoses: definition
    • General features of the mucopolysaccharidoses
    • Classification of the mucopolysaccharidoses
    • Classification of the mucopolysaccharidoses, continued
    • Airway management in the mucopolysaccharidoses
    • Osteogenesis imperfecta: definition
    • Systemic features of osteogenesis imperfecta
    • Anesthetic considerations in osteogenesis imperfecta
    • Preoperative assessment in osteogenesis imperfecta
    • Anesthetic technique in osteogenesis imperfecta

    52 slides

  5. 05

    Anemias

    • Anemia: definition and perioperative importance
    • Types of anemia
    • Types of anemia (continued)
    • Compensatory mechanisms to increase oxygen delivery with chronic anemia
    • Iron deficiency anemia
    • Folate and vitamin B12 deficiency anemia
    • Hemolytic anemia: definition
    • Hereditary spherocytosis: features
    • Splenectomy in hereditary spherocytosis
    • Glucose-6-phosphate dehydrogenase deficiency
    • Drugs that can produce hemolysis in glucose-6-phosphate dehydrogenase deficiency
    • Drugs that can produce hemolysis in glucose-6-phosphate dehydrogenase deficiency (continued)
    • Drugs that can produce hemolysis in glucose-6-phosphate dehydrogenase deficiency (continued)
    • Pyruvate kinase deficiency
    • Hemolytic transfusion reactions
    • Hemoglobinopathies: definition
    • Hemoglobin variants
    • Sickle cell disease: genetics and mechanism
    • How sickling happens
    • Mechanisms of cellular and tissue injury in sickle cell disease
    • Mechanisms of cellular and tissue injury in sickle cell disease (continued)
    • Sickle cell trait versus sickle cell disease
    • Acute chest syndrome
    • Complications of sickle cell disease
    • Complications of sickle cell disease (continued)
    • Preoperative evaluation in sickle cell disease
    • Intraoperative management of sickle cell disease
    • Thalassemia: mechanism
    • Anesthetic management of thalassemia

    29 slides

  6. 06

    Connective Tissue Diseases

    • Rheumatoid arthritis: features
    • Extra-articular manifestations of rheumatoid arthritis
    • Preoperative evaluation in rheumatoid arthritis
    • Cervical spine MRI in rheumatoid arthritis
    • Cervical spine instability in rheumatoid arthritis
    • Adverse effects of drugs used to treat connective tissue diseases
    • Adverse effects of drugs used to treat connective tissue diseases (continued)
    • Adverse effects of drugs used to treat connective tissue diseases (continued)
    • Adverse effects of drugs used to treat connective tissue diseases (continued)
    • Systemic lupus erythematosus: definition
    • Cardiovascular manifestations of systemic lupus erythematosus
    • Systemic sclerosis: definition and mechanism
    • Vascular access and airway in systemic sclerosis
    • Aspiration risk in systemic sclerosis
    • Regional anesthesia in systemic sclerosis
    • Inflammatory myopathies: definition
    • Rocuronium and sugammadex in dermatomyositis

    17 slides

  7. 07

    Skin Disorders

    • Epidermolysis bullosa: mechanism
    • Ultrastructure of the skin zones in epidermolysis bullosa
    • Subtypes classified by level of skin separation
    • Dystrophic epidermolysis bullosa
    • Blistering and pseudosyndactyly in epidermolysis bullosa
    • Protecting the skin during anesthesia
    • Airway management in epidermolysis bullosa
    • Pemphigus: definition
    • Anesthetic management of pemphigus

    9 slides

  8. 08

    Summary and Key Points

    • Key points: muscle and neuromuscular junction
    • Key points: nervous system and inherited disorders
    • Key points: blood, connective tissue and skin
    • Drugs to approach with caution across these diseases
    • A general approach to the rare coexisting disease
    • References
    • References (continued)
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    • References (continued)
    • References (continued)
    • Barash, Cullen, and Stoelting's Clinical Anesthesia, 9th Edition

    18 slides