Lesson 268: PreAnesthetic Assessment of the Patient With HIV Infection

Course Authors:

Amir Baluch, MD Anesthesia resident, Jackson Memorial Hospital/University of Miami Leonard M. Miller School of Medicine, Miami, Florida

Abhinav Gautam Medical student, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana

Alan Kaye, MD, PhD Professor and Chairman, Department of Anesthesiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana

Registration Fee: $15.00
2.0 AMA PRA Category 1 CreditsTM
available until
November 30, 2008

Please be sure to read registration information below.

 

Registration links are at the bottom of the page.

Reviewed by:

James Riopelle, MD Professor of Anesthesiology, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana

Review Date: July, 2007

NEEDS STATEMENT

Infection with HIV is a systemic, multiple-organ process for which therapeutic modalities are continuing to evolve. A familiarity with the disease and current therapies is necessary before the anesthetic management of patients is planned. Drug interactions, pulmonary complications, opportunistic infections, and malignancies are more prevalent in this group of patients and may create a challenging environment for the anesthesiologist.

     
CASE HISTORY

A 38-year-old homosexual man, scheduled for elective hemorrhoidectomy, complains of progressive pain while swallowing (odynophagia) the day before surgery. The patient is able to swallow liquids and denies any history of reflux disease, ulcers, or hiatal hernia. The physical examination findings are unremarkable, and an upper gastrointestinal study is performed. The gastroenterologist finds white, cheesy exudates in the esophagus and diagnoses esophageal candidiasis.

   

LEARNING OBJECTIVES

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

  1. Summarize the special anesthetic problems presented by patients infected with HIV.

  2. Describe the systemic changes and symptoms associated with the disease.

  3. Apply appropriate preoperative testing and evaluation in this group of patients.

  4. Outline the genetic and risk factors for the disease.

  5. Describe the most common modes of transmission.

  6. Present an anesthetic and analgesic plan.

  7. List associated complications.

  8. Cite the incidence of the disease.

  9. Anticipate, recognize, and manage likely perioperative complications.

  10. Discuss drug interactions that may be observed during the perioperative period.Recognize the progressive nature of the disease.

TARGET AUDIENCE:  Anesthesiologists

INSTRUCTIONS FOR COMPLETING THIS COURSE

The estimated time to complete this activity is 2 hours. There are two options for completing this CME activity.

Option 1: Exam Only.  This option can only be exercised by subscribers to Anesthesiology News who possess a material copy of the course.  Participants who select this option must read the article in the journal, reflect on the information presented, and then register to complete the exam and course evaluation online before November 30, 2008. (CME credit is not valid past this date.)  

To register for the exam only, click on the Register For Exam link located at the bottom of this page. DO NOT select this option if you do not possess a material copy of the CME course material.

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.

Option 2: Course Material and Exam.  All participants are eligible for this option.

You must first register for this course by clicking the "Register for Course" link located at the bottom of this page.  Course material is presented in small digestible sections followed by exam questions pertaining to the information in the segment covered.  As you read through the material on the course pages, you will occasionally be prompted to answer exam questions. 

There are several short pages of information and 10 multiple choice questions presented in this course.  You must achieve a minimum grade of 80% (8 correct answers) to receive CME credit. The exam and course evaluation must be completed before November 30, 2008. (CME credit is not valid past this date.)  

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When you have answered the last exam question, the Course Results page will display. This page will contain your final grade and allow you to immediately view/print your Certificate if you have achieved the minimum passing score of 80%. 

Upon successful completion, your Certificate will be available at all times from your Student Control Panel.   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 course does not need to be completed in a single online session. You can log off at any point and return to the course at your convenience.  If you wish to obtain more information regarding the features of this site, you may visit the Orientation page.  Click here to view Orientation.

REGISTRATION

The registration fee for this course is $15.00

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

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 authors, the reviewer, and the editor have no relationships 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.support6@proceo.com.

All other requests for administrative assistance should be directed to Josephine Greene in the CME office at the Mount Sinai School of Medicine : 212-241-4441 or send email to Josephine.Greene@msnyuhealth.org

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

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EXAM ONLY

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Click Here to REGISTER FOR COURSE AND EXAM

This option is available for all participants. This option includes a full online text version of the course material and exam.