Digoxin is a medication that is commonly used for congestive heart failure (CHF) and arrhythmias like atrial fibrillation or flutter with rapid ventricular rates (RVR). It has largely been replaced by medications that have a safe side-effect panel like beta-blockers and calcium channel blocks, but you will still see patients on this medication every now and then. Even though prescribing this medication is reserved for cardiology, it is still important for perioperative providers to understand how this medication works and why it is used.

The ITE (or In-Training Exam) is an annual exam for Anesthesiology trainees that tests their clinical knowledge. Residency programs typically use it as a benchmark for likelihood of passing the BASIC and ADVANCED Board Exams. These two sheets are designed to be high-yield cram sheets of factoids that I felt like were commonly tested and easy to memorize for the test.

Glucagon is a hormone in the body that helps maintain homeostasis, specifically regarding glucose (sugar) levels. While we sleep at night, our bodies are fasting and not taking in glucose or nutrition. Glucagon is able to maintain normal levels of blood glucose levels so that we don’t go into a state of hypoglycemia (low blood sugar).

One of the more significant complications of thoracoabdominal aortic surgery is ischemic spinal cord injury (SCI). The result of this can be paralysis and lack of sensation to both lower extremities. This can present immediately after surgery (acute) or be delayed for several days (postponed). Placing a lumbar cerebrospinal fluid (CSF) drain can reduce the risk of SCI by reducing the intraspinal pressure (or ICP) and allowing more perfusion to the spinal cord. Spinal cord perfusion is determined by mean arterial pressure minus intracranial pressure (SCP = MAP - ICP). ICP can be replaced with central venous pressure (CVP) in this equation, depending on which is higher.