A 75-year-old woman presented to the emergency department following a fall in which she sustained a fractured right hip. She has no other injuries and is cognitively intact. She has been scheduled for a right hemiarthroplasty as the first case on the operating list tomorrow morning.
Past medical history
Polymyalgia rheumatica
Chronic alcohol consumption (60 g per day)
Previous deep vein thrombosis with pulmonary embolism
Chronic kidney disease
Height: 162cm Weight: 61kg
Medications
Fluoxetine 40 mg mane
Perindopril/indapamide 5 mg/1.25 mg mane
Prednisolone 15 mg mane
Rivaroxaban 15 mg mane
Rosuvastatin 20 mg mane
Blood test results on admission to the emergency department:
Haemoglobin 82 g/L (115-160)
Platelets 117 x10^9/L (150-450)
Na+ 127 mmol/L (135-145)
K+ 4.2 mmol/L (3.5-5.5)
Cl- 103 mmol/L (95-110)
HCO3- 20 mmol/L (20-32)
Urea 12 mmol/L (2.5-7.0)
Creatinine 145 mmol/L (45-95)
eGFR 30 mL/min/1.73m2 (>90)
Albumin 26 g/L (33-46)
A cardiac rhythm strip was printed in the Emergency Department.
Sections covered in this viva
Preoperative AssessmentGeneral Anaesthesia ManagementDelayed Recovery and Hyponatraemia