| NEEDS STATEMENT
Anesthesiologists are frequently called on to care for patients
with muscular diseases whose condition may be adversely affected
by the drugs used for muscle relaxation. The identification of
such patients and their appropriate management have been cited by
readers and the editorial board committee of Anesthesiology News
as necessary information for the practicing anesthesiologist.
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| CASE HISTORY A
15-year-old boy with severe scoliosis was admitted for
arthrodesis of the spine. The levoscoliosis of his
thoracolumbar spine was 58 degrees by the method of Cobb.
His medical history was significant for severe DMD
associated with congestive heart failure and respiratory
insufficiency. The patient’s weight was 81 kg and his
height approximately 56 inches, estimated by arm span. A
physical examination revealed a hypertrophic tongue and a
Mallampati grade II airway. Muscle strength in his lower
extremities was documented at 1 to 2 (of 5) on the Medical
Research Council Scale. The patient was confined to a
wheelchair but was able to brush his teeth and feed
himself with difficulty.
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LEARNING OBJECTIVES
At the end of this activity, the participant should be able to:
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Describe the pathophysiology of
Duchenne’s muscular dystrophy (DMD).
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Identify the differences between
Becker’s muscular dystrophy and DMD.
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Discuss the organ systems affected
by DMD.
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List the preoperative
considerations for the anesthetic care of the patient with DMD
who requires general anesthesia.
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Outline an appropriate preoperative
evaluation.
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Discuss the controversy surrounding
the use of inhalational anesthetics in the management of
patients with DMD.
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Describe the effects of
neuromuscular blockade.
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Develop an anesthetic plan.
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Manage postoperative anesthetic
care.
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 October 31, 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 October 31, 2008. (CME
credit is not valid past this date.)
The course software does not permit you to page back from the exam
questions. You must be sure that you understand the material
presented on each page before proceeding.
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.
Disclosure Statement
The author, reviewer, and 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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This option is for the examination
ONLY. No course material is provided. This option
is available for subscribers of Anesthesiology News who
possess a material copy of the course material. DO NOT select
this option if you do not have the course material. |
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This option is available for all participants. This option
includes a full online text version of the course material and
exam. |
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