Lesson 286: PreAnesthetic Assessment of the Patient with Goodpasture's Syndrome

Course Authors:

Keri Copponex, Medical student, Louisiana State University School of Medicine, New Orleans, Louisiana; Alan D. Kaye, MD, PhD, Professor and chairman, Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, Louisiana

Registration Fee: $15.00
2.0 AMA PRA Category 1 CreditsTM
available until June 30, 2011

Reviewed By:

Charles J. Fox, MD, Associate professor, Department of Anesthesiology, Tulane University School of Medicine, New Orleans, Louisiana

Review Date: May, 2010
REGISTRATION INFORMATION:

Participants who do not possess a copy of Anesthesiology News can download and print the course material in an easy to read convenient  format.  Participants must reflect on the information presented, and then register to complete the exam and course evaluation online before the availability date listed above.  (CME credit is not valid past this date).  

Click on the link below to download and print the course material and post-test exam.  Register for the exam to enter your responses to receive CME credit.  There are ten questions in the examination and you must achieve a score of 80% or better to earn CME credit.  Following successful completion, your certificate will be immediately available online.  In addition, a historical record of  completed CME courses is maintained online in an individualized profile.  This includes copies of course certificates which can be printed at any time.

The registration fee for this course is $15.00

Physicians are provided with two opportunities to successfully complete the exam presented here. 

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NEEDS STATEMENT

Goodpasture’s syndrome (GS), an autoimmune disease, presents challenges for the anesthetic care of patients, particularly because of effects on the respiratory and renal systems. Perioperatively, the anesthesiologist should be able to appropriately manage these patients. Rarely en-countered disease states have been identified as important topics for clinical anesthesiologists.

CASE HISTORY

A 26-year-old man presented with a 5-year history of GS, confirmed by a renal biopsy. Due to his declining renal function, placement of an arteriovenous graft for renal dialysis was scheduled. A review of systems indicated slight dyspnea and occasional hemoptysis. Pulmonary function tests conducted 2 months previously indicated mild restrictive lung disease.

LEARNING OBJECTIVES

At the end of this activity, the participant should be able to:

  1. Define GS.

  2. Review special problems associated with the administration of anesthetics to patients with GS.

  3. Describe the pulmonary and renal manifestations seen in these patients.

  4. Explain the pathogenesis of GS.

  5. Apply appropriate preoperative testing and evaluation of patients.

  6. Discuss the findings of laboratory tests.

  7. Present an anesthetic and analgesic plan for the treatment of patients with GS.

  8. Discuss treatment options.

  9. Cite the incidence and prevalence of GS.

  10. Anticipate, recognize, and manage likely perioperative complications associated with GS.

TARGET AUDIENCE:  Anesthesiologists

Accreditation Statement

Mount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The Mount Sinai School of Medicine designates each educational activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

It is the policy of Mount Sinai School of Medicine to ensure objectivity, balance, independence, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices.

Disclosures

Dr. Kaye has disclosed that he is a member of the speakers’ bureau of Baxter. The other author, the reviewer, and the editor have no relation-ships with pharmaceutical companies or manufacturers of products to disclose. This educational activity may contain discussion of published and/or investigational uses of agents for the treatment of disease. Some uses of these agents have not been approved by the FDA. Please refer to the official prescribing information for each product for approved indications, contraindications, and warnings.

CONTACT INFORMATION

Questions regarding course content may be directed to Dr. Elizabeth Frost: ElzFrost@aol.com.

If you require technical assistance with completing this course, please contact Continuing Education Online Customer Service at 718-648-8080 or send e-mail to ceo.contact7@proceo.com.

CALL FOR WRITERS

If you would like to write a CME lesson in Anesthesiology News, please send an e-mail to Elizabeth A.M. Frost, MD, at ElzFrost@aol.com