Med Viva Stems Flashcards
22.1 VIVA 1 - mean 5.98
You are in the preadmission anaesthesia clinic. A 57 year old male presents to the clinic prior to extracorporeal shockwave lithotripsy for a staghorn calculus. His past medical history includes systemic sclerosis.
Medications listed are:
Prednisone 2.5 mg daily
Mycophenolate 3g daily
Insulin Humalog 16 units three times daily and Lantus 25 units at night
Apixaban 5mg twice daily
Irbesartan 300mg daily
Vitamin D 1000 IU daily
Magnesium 500mg twice daily Artificial tears prn
Systemic sclerosis is a multisystem disorder – what will you ask in the HISTORY to assess the severity and stability of his systemic sclerosis?
Investigations included:
Pulmonary function tests
CXR
Full blood picture
Urea and electrolytes 6 minute walk test
Minimum standard criteria were:
1. Awareness of cardiorespiratory manifestations of SS
2. Makes a reasonable functional assessment, knows what CVS/resp examination findings to
look for
3. Formulates a differential diagnosis for dyspnoea and makes a realistic plan for how to
establish the cause (CVS vs resp)
4. Correct interpretation of PFTS (FEV1/FVC), CXR
22.1 VIVA 2- mean 6.15
You are reviewing a 71year old male in the pre-anaesthetic clinic. He is scheduled for a total knee replacement in 2 weeks.
Current medications:
Frusemide 20mg daily
Rivaroxaban 20mg daily
Digoxin 125mcg daily
Bisoprolol 10mg twice daily Sacubitril/valsartan 97/103mg twice daily Rosuvastatin 10mg daily
Ezetimibe 10mg daily
With these medicines, what cardiovascular conditions are you most concerned about?
Investigations included:
CXR
ECG
Iron studies Biochemistry
Complete blood picture
Minimum standard criteria
1. Ability to discuss significance of medications
2. Ability to outline signs and symptoms of heart failure
3. Ability to request appropriate investigations and interpret them
4. Ability to identify significance of the implantable cardioverter defibrillator (ICD) – recognize
appropriate indications for insertion and significance of interrogation findings
