A 47-year-old woman with acromegaly attends your preoperative assessment clinic one week prior to undergoing a transsphenoidal hypophysectomy for pituitary adenoma. She has a history of hypertension and type II diabetes mellitus. She is a heavy smoker, has a hoarse voice and reports a recent hospital admission for investigation of shortness of breath on exertion.
Medications:
- lisinopril 20 mg daily
- metformin 1000 mg nocte
- metoprolol 100 mg mane
- octreotide 75 mcg subcutaneously x 3 daily
Sections covered in this viva
Preoperative assessment including OSA and hypertensionManagement of induction and extreme hypertension with topicalisationManagement of high urine output and diabetes insipidus postoperatively