achilles
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A 76-year-old man is undergoing an abdominoperineal resection for rectal cancer. During the surgery, unexpected severe bleeding is encountered, and the patient is hypotensive on and off for almost an hour. The anesthesiologist notes ST depression and T-wave flattening on the ECG monitor. Which of the following is the most likely diagnosis and the expected mortality?
A. Intraoperative air embolus, 100%
B. Myocardial infarction, 5% to 10%
C. Myocardial infarction, 50% to 90%
D. Pulmonary embolus, 5% to 10%
E. Pulmonary embolus, 50% to 90%
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| chemamr
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A?? not sure really
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| stepkiller
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i go for E
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| reet
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I guess E
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| DrS
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B. Myocardial infarction, 5% to 10%
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| cooldudemle
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i would go with c .. myocardial infarction (ST depression and T wave flattening)and 50-90% mortality this mortality exceeds that of mi in anormal setting. as on page 23 kaplan surgery notes.perioperative mi.
pulmonary embolus will typically occur around post op day 7. whats the correct answer achilles?
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| chemamr
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what´s the answer here and why, please give the explanation achilles.
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| achilles
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The correct answer is C.
Intraoperative myocardial infarction is mostly seen in elderly men, and the most common triggering event is prolonged hypotension. Furthermore, the mortality greatly surpasses that of a myocardial infarction de novo (ie, unrelated to surgery , which is 5%-10%) reaching the levels quoted.
Air embolism can happen when big veins are open, allowing air to be sucked in. however, the location of the open veins is typically the upper chest or lower neck. The patient dies while undergoing a procedure under local anesthesia, breathing spontaneously rather than having air blown into his lungs. and the veins have to be higher than the level of heart at that moment for the air to be sucked in.
Pulmonary emboli are not usually seen during surgery; they typically occur 5-7 days later. so they cant be the answer in such cases.
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| chemamr
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alright 
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| stepkiller
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is this given in kaplan book.please tell me because other wise i would read some other books
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| kald
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its given in kaplan notes and the question is in Q bank with explanation
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