/study/clinical-day-prep
Clinical day prep
"Thyroidectomy tomorrow. Shoulder + interscalene next week." Use the case library — every entry has the patient phenotype, anesthetic plan, biggest concerns by phase, mock-defense scenarios. Open the case, read it through, you're prepped.
Most-prepped cases
Pick the case you're facing tomorrow:
Most commonly female, 30s–50s, BMI often elevated, occasional cardiopulmonary disease. Typical American: GERD, obesity, sometimes diabetes. Outpatient unless conversion or comorbidity.
Acute abdomen — perforated viscus, ischemic bowel, ruptured AAA, gunshot/trauma. Often septic, hypovolemic, full stomach. Age varies wildly.
Typically male 55–75, multi-vessel CAD, often diabetic, ex-smoker, on dual antiplatelet + statin + β-blocker. May have preserved or reduced EF. Last meal NPO since midnight.
Term pregnant woman (37+ weeks), repeat C/S or breech or maternal request. Aspiration risk by definition. Possible PIH, GDM, obesity. Most awake under spinal.
Typically 60–80, OA-driven, often obese, frequently HTN + diabetes + sometimes CAD. Outpatient or 1-night admit. Increasing use of regional anesthesia + ERAS pathways.
Usually 40–70, brain tumor (glioma, meningioma, mets). May have raised ICP, seizures, focal neuro deficit. Often on dexamethasone + AEDs (levetiracetam).
Usually 3–10 years old. Recurrent tonsillitis or OSA. Often current/recent URI. Mask induction, IV after asleep. Outpatient unless OSA or comorbidity requires admission.
Typically 60–80, atherosclerotic, often with CAD + HTN + DM + COPD + hyperlipidemia. Symptomatic (TIA, amaurosis fugax) or asymptomatic ≥ 70% stenosis.
Lung cancer or large nodule. Typically 55–80, smoker / ex-smoker, COPD often present, possibly reduced DLCO + FEV1. Consider preop pulmonary rehab + smoking cessation.
Typically male 65–85, multi-vessel CAD, COPD, smoker. Symptomatic = back/flank pain or pulsatile mass. Ruptured = hypotensive + altered mental status (true emergency, separate plan).
End-stage liver disease (cirrhosis, HCC, alcoholic, NAFLD, viral hepatitis). Hepatorenal syndrome, encephalopathy, coagulopathy, varices, hyperdynamic circulation often present. MELD ≥ 15 typical.
Infant 3-12 weeks old, projectile non-bilious vomiting, dehydration. Hypochloremic, hypokalemic, metabolic alkalosis classic ('paradoxical aciduria' as a late finding). Surgery is NOT emergent — it's a metabolic emergency that needs correction first.