Organ-Sciences 2

Organ-Based Sciences for the Anesthesia Written Boards - Part 2

Cardiovascular System

  • Normal Anatomy of Heart and Major Vessels: Echocardiography (Chambers, Valves, Great Vessels, Pericardium, Basic), Transesophageal Echocardiography [TEE] Views, Radiographic Views (Roentgenograms, CT, MRI), Other
  • Ischemic Heart Disease: Risk Factors, Predictors of Perioperative Risk, Modification of Perioperative Risk (e.g., Prophylactic Beta-Blockers), Manifestations, Diagnosis of Myocardial Infarction and Acute Coronary Syndrome (Clinical, ECG, Enzymes, Echocardiography, Nuclear Techniques), Classification of types of MI (STEMI vs. demand), Pharmacological Treatment of Angina, Thoracic Epidural for Angina, Interventional Cardiologic Techniques, Determinants of Myocardial Oxygen Requirements and Delivery, Silent Ischemia, Postoperative Ischemia, Perioperative Diagnosis and Treatment of Ischemia (ECG, TEE), Coronary Artery Bypass Procedures, Cardiopulmonary Bypass (Off-Pump, Techniques)
  • Valvular Heart Disease: Classification, Diagnosis (Including Echocardiography), Natural History, Surgical Management, Anesthetic Consideration, Subacute Bacterial Endocarditis Prophylaxis, Rhythm Disorders and Conduction Defects (Chronic Abnormalities: Etiology, Diagnosis, Therapy), Automated Implantable Cardioverter/Defibrillator (AICD) Implantation, Pacemakers (Permanent, Temporary, Transvenous, Transcutaneous;
    Ventricular Synchronization), Ablations, Cryotherapy, Maze Procedure
  • Perioperative Dysrhythmia, Etiology, Diagnosis, Therapy, Perioperative Implications of Pacemaker and AICD
  • Heart Failure and Cardiomyopathy (Ischemic, Viral, Hypertrophic), Definition and Functional Classification, Perioperative Diagnosis and Treatment, Compensatory Responses, Right or Left Ventricular Dysfunction, Etiology, Signs and Symptoms, Diagnostic Tests, Systolic vs. Diastolic Dysfunction, Treatment (Pulmonary Edema, Pulmonary Hypertension, Cardiogenic Shock), Cardiac Transplantation, Cardiac Tamponade and Constrictive Pericarditis (Etiology, Diagnosis [TEE, PA Catheter], Anesthetic Management)
  • Circulatory Assist: Cardiopulmonary Bypass (Components [Pump, Oxygenator, Heat Exchanger, Filters]), Cardiopulmonary Bypass Techniques, Mechanisms of Gas Exchange, Priming Solutions, Hemodilution, Anticoagulation and Antagonism (Activated Clotting Time [ACT] and Other), Clotting Times, Heparin Assays, Antithrombin III, Protamine Reactions, Heparin and Protamine Alternatives, Prophylaxis (Aminocaproic Acid, Tranexamic Acid), Anesthetic Considerations During Bypass, Extracorporeal Membrane Oxygenation [ECMO], Cooling and Warming, Deep Hypothermic Circulatory Arrest, Monitoring, Blood Pressure Management, Minimally Invasive Bypass Techniques, Myocardial Preservation: Physiology, Techniques, Complications, Preconditioning
  • Minimal Invasive Cardiac Surgery: Off-pump coronary artery bypass (OPCAB), Minimally invasive direct coronary artery bypass (MIDCAB), Percutaneous valve repair/replacement
  • Intraaortic Balloon: Rationale, Indications, Limitations
  • Ventricular Assist Devices and Artificial Heart: Internal and External
  • Pulmonary Embolism: Etiology (Blood, Air, Fat, Amniotic Fluid), Diagnosis, TEE Findings, Treatment; Acute, Preventive
  • Hypertension: Etiology, Pathophysiology, Course of Disease, Drug Treatment (Interactions with Anesthetics, Risk of Anesthesia), Intra or Postoperative Hypertension (Differential Diagnosis and Treatment), Shock States (Anesthetic Management of Patient in Shock)
  • Vascular Diseases: Cerebral Circulation, Luxury Perfusion, Steals, Infarcts, Intracranial Hemorrhage, Carotid Endarterectomy (Anesthetic Management, Monitoring of Cerebral Perfusion, Complications), Abdominal Aneurysm Resection, Peripheral Arteriosclerotic Disease, Anesthetic Management
  • Cardiopulmonary Resuscitation: Recognition, Management (Drugs, Defibrillators, Monitors, Advanced Cardiac Life Support [ACLS]) Algorithms, Complications and Outcomes of Therapy, Pediatric/Adult Differences

Gastrointestinal/Hepatic Systems

  • Biochemistry: Parenteral Nutrition (Peripheral Or Central Vein, Hyperalimentation, Solutions Used, Complications, Anesthetic Implications), Enteral Nutrition (GI Elemental Diets, Routes of Delivery, Complications, Anesthetic Implications)
  • Morbid Obesity/Anesthesia for Bariatric Surgery: Pre-Anesthetic Evaluation and Management, Pharmacologic Considerations, Anesthetic Management (Airway, Ventilation, Monitoring, Venous Access), Postoperative Management (Ventilation, Analgesia)
  • Hepatic Disease: Preoperative Laboratory Assessment, Anesthesia Choice (Hepatocellular Disease, Ascites, Portal Hypertension), Postoperative Hepatic Dysfunction, Hepatic Failure, Hepatorenal Syndrome, Hepatic Transplantation
  • Intestinal Obstruction: Causes (Paralytic Ileus, Mechanical, Vascular), Physiological Changes (Fluid and Electrolyte, Respiratory), Anesthesia Management (Full Stomach, Fluid Therapy, Nitrous Oxide)

Renal and Urinary Systems/Electrolyte Balance

  • Pathophysiology of Renal Disease: Risk Factors for Acute Renal Failure, Anesthetic Choice in Reduced Renal Function, Anesthetic Management in Renal Failure, Arteriovenous (A-V) Shunts
  • Anesthetic Management in Renal Transplantation
  • Perioperative Oliguria and Anuria
  • Dialysis and Hemofiltration: Hemodialysis, Peritoneal Dialysis, Continuous Hemofiltration (Arteriovenous, Venovenous)
  • Pharmacologic Prevention and Treatment of Renal Failure
  • Urologic Surgery: Lithotripsy, Transurethral Resection of Prostate (TURP)/Irrigating, Fluid Overload and Hyponatremia
  • Perioperative Electrolyte Abnormalities

Hematologic System

  • Diseases of Blood: Anemias, Compensatory Mechanisms, Polycythemias; Primary vs. Secondary, Clotting Disorders (Thrombocytopenia and Thrombocytopathy, Congenital and Acquired Factor Deficiencies, Disseminated Intravascular Coagulation, Fibrinolysis)
  • Pharmacologic: Anticoagulants and Antagonists
  • Hemoglobinopathies, Porphyrias

Endocrine and Metabolic Systems

  • Pituitary Disease: Hypopituitarism, Pituitary Removal, Replacement Therapy, Panhypopituitarism, Diabetes Insipidus, Hyperpituitarism (Acromegaly, Including Airway Management), Inappropriate ADH Secretion
  • Thyroid Disease: Hyperthyroidism (Metabolic and Circulatory Effects, Anesthetic Management, Thyroid Storm), Hypothyroidism (Metabolic and Circulatory Effects, Myxedema Coma, Replacement Therapy, Anesthetic Implications), Complications of Surgery (Hypocalcemia, Recurrent Laryngeal Nerve Injury, Diagnosis and Treatment)
  • Adrenal Disease: Cushing’s Syndrome, Primary Aldosteronism, Addison’s Disease, Pheochromocytoma (Circulatory and Metabolic Manifestations, Diagnosis, Anesthetic Management), Carcinoid Syndrome, Diabetes Mellitus (Pathophysiology, Control of Blood Glucose – Hypoglycemia, Hyperglycemia, Ketoacidosis), Elective Anesthesia – Perioperative Management, Emergency Anesthesia, Hyperosmolar Coma, Pancreas Transplantation)
  • Parathyroid Disease: Hyperparathyroidism (Physiological Effects), Hypoparathyroidism, Postoperative Manifestations and Treatment

Neuromuscular Diseases and Disorders

  • Demyelinating Diseases (Multiple Sclerosis, Motor Neuron Diseases [Amyotrophic Lateral Sclerosis, Spinobulbar Muscular Atrophy,
    Hereditary Spastic Paraplegia], Guillain-Barre Syndrome, Charcot-Marie-Tooth Disease
  • Primary Muscle Diseases: Muscular Dystrophies (Duchenne’s, Becker’s, Limb-Girdle, Congenital, Myotonic), Mitochondrial Myopathies, Channelopathies, Myasthenic Syndromes, Myasthenia Gravis, Lambert-Eaton Myasthenic Syndrome, Congenital Myasthenic Syndromes, Ion Channel Myotonia (Acquired Neuromyotonia, Myotonia Congenita, Hyperkalemic Periodic Paralysis, Paramyotonia Congenita, Postassium-Aggravated Myotonia, Hypokalemic Periodic Paralysis)
Organ-Sciences 2
Course Information
Dr. Michael Ho
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