1. Peds Flashcards
1
Q
full term
A
37-41 weeks gestational age
2
Q
preterm
A
< 37 weeks
3
Q
Small for gestational age
A
birth weight < 10th %
4
Q
Large for gestational age
A
birth weight > 10th %
5
Q
embryonic lung development
A
4-7 weeks gestation
6
Q
psuedoglandular lung development
A
5-17 wks gestation
7
Q
canalicular lung development
A
16-26 wks gestation
8
Q
saccular lung development
A
24 wks to birth
9
Q
alveolar lung development occurs
A
after birth to 3 years
10
Q
when does the bronchial tree develop?
A
pseudoglandular stage
11
Q
when does the differentiation of type 1 and type 2 surfactant occur?
A
canalicular stage
12
Q
when is surfactant mature?
A
saccular stage
13
Q
how many alveoli at birth?
A
30-50 million
14
Q
amniotic fluid function
A
protects baby
15
Q
fetal breath movements (FBM)
A
pulls fluids into lungs
opens alveoli
stimulates growth
16
Q
amniotic fluid contains
A
urine and lung secretions
17
Q
fetal blood from IVC flows
A
through foramen ovale
18
Q
fetal blood from SVC flows
A
through trucsupid
19
Q
fetal lungs PVR
A
higher due to HPV
20
Q
fetal circulation is _____ while adult circulation is ______
A
fetal circulation is 2 parallel circuits while adult circulation is 1 circuit in series
21
Q
umbilical arteries carry
A
deoxy blood
22
Q
umbilical vein carry
A
oxy blood
23
Q
umbilical vein PO2
A
55 mmHg
24
Q
fetal hb subunits
A
2 alpha
2 delta
25
fetal hb p50
19 mmHg
26
fetal hb-o2 shift
Left Shift
27
what happens to BF through PDA at birth
decr SVR causes BF to bypass PDA
28
what closes PFO
incr pulm circulation
incr LA P
29
how do you avoid baby hypoxia at birth
delayed cord clamping
30
infant ribs/diaphragm
parallel ribs
flatter diaphragm
compensate by **incr RR**
31
infants response to CO2
decr ventilatory response
32
infants response to hypoxic mixture
incr ventilation for 1 min
5 min hyponea
33
infants response to hypoxic mixture due to
immature carotid bodies
34
infant respiratory diffferences
decr TLC
decr TV
decr FRC
incr O2 consumption
incr MV
incr closing capacity (incr atelectasis risk)
35
infant diaphragm compostion
25% type 1 aerobic muscle fibers means they need mechanical ventilation help bc tire easily
36
infant airway differences
larger tongue
cephalad larynx
narrow omega epiglottis
angled vocal cords
37
narrowest part of infant airway
cricoid cartilage
38
level of glottic opening: preterm infant
C3
39
level of glottic opening: fulterm infant
C3-C4
40
level of glottic opening: adult
C4-C5
41
pediatric SV
fixed due to non-compliant LV
42
pediatric CO
HR-dependent
43
are peds pts parasympathetic or sympathetic dominant?
parasympathetic
44
peds renal drug elimination
decr renal drug elimination
incr DOA
45
peds urine
dilute
46
Cr at birth
same as mother
47
Cr 48 hrs post-birth
0.5 mg/dL
48
[Hg] at birth
19 g/dL
49
HgF at birth
70%
50
why is peds Hg so high?
incr EPO
51
cranial sutures
elastic tissue bands
- fontanels at junction of cranial sutures
52
anterior fontanel closes
20 months
53
posterior fontanel closes
3 months
54
which drug is neuroprotective
dexmedetomidine
55
which drugs do not cause neuroapoptosis
narcots
56
PANDA study
no sig difference in IQ when exposed to anesthetics
57
GAS study
no diff in neurodevelopment at 5 yrs
58
Mask Study
no statistica difference between kids w or w/o anesthetic exposures
59
risk of anesthesia in peds incr with
longer duration
increased frequency
60
peds drugs with hepatic metabolism
longer DOA
61
fentayl metabolism by newborn
50%
62
full-term neonate glycogen
similar to adults
63
peds oral midazolam dosing
0.3-0.7 mg/kg
64
oral midazolam onset
10 mins
65
peds precedex doing
2 mcg/kg
66
peds precedex onset
20-30 mins
67
how should you dose peds
based off of ideal body weight
68
IBW
IBW = 2*age +10
69
neonate -12 mo mask size
2
70
12 mo - 4 yr mask size
3
71
4-12 yr mask size
4
72
12+ yr mask size
5
73
uncuffed ETT
age/4 + 4
74
cuffed ETT
age/4 + 3.5
75
ETT depth
3* ID
76
where does uncuffed tube seal
at cricoid
77
improper tube sizes can cause
edema due to incr resistance
78
LMA 1
<5 kg
79
LMA 1.5
5-10 kg
80
LMA 2
10-20 kg
81
LMA 2.5
20-30 kg
82
LMA 3
females over 30 kg or 10 yrs
83
LMA 4
males over 30 kg or 10 years
84
which airway has decr laryngospasm
LMA
85
infants < 3 warming mechanism
non-shivering thermogenesis via brown fat metabolism
86
how to manage peds temperature
warm room
warm IV fluids
forced air warmers
airway humidification
87
most common cause of ped cardiac arrest
respiratory compromise
88
sunken fontanel can indicate
hypovolemia
89
respiratory disress syndrome
preterm infant born w/Type 2 pneumocyte deficiency
**delayed surfactant production**
50% surfactatn by 28 weks
100% by 36 weeks
90
risk in RDS pts
pneumothorax
91
bronchopulmonary dysplasi
alveolar hyperplasia
arrest of alveolar development
92
pts in bronchopulmonary dysplasia need
supp O2 for at least 28 days after birth
O2 dependenc at 36 weeks PCA
93
what should you avoid unless absolutely necessary in bronchopulmonary dysplasia pts
intubation
94
laryngomalaci
flaccidity or laryngeal structures corrected with supraglottoplasy
95
laryngomalacia managment
CPAP
PPV
96
bronchomalacia
weakened cartilage of major airways causing airway collapse
97
bronchomalacia respiratory disease type
expiratory with PPV
inspiratory wtih SV
98
what anesthetic is used for diagnosis of laryngomalacia and bronchomalacia
bronchoscopy with TIVA
99
airway decadron dose
0.5 mg/kg
100
adenotonsillar hypertrophy causes
congenital
chronic tonsillitis
101
what should you not give adenotonsillar hypertrophy pts
midazolam
avoid toradol
102
primary bleeding tonsil timeline
24 hrs post surgery
103
secondary bleeding tonsil timeline
days 5-7 or 10-14
104
anesthetic for drug induced sleep endoscopy
1-2 mcg/kg precedex
105
apnea of prematurity
cessation of breathing > 20 seconds
SaO2 < 90%
106
APO treatment
nasal CPAP
caffeine
aminophylline
107
congenital diaphragmatic hernia triad
dyspnea
cyanosis
dextrocardia
108
most common type of CDH
bochdalek
109
CDH treatment
intubate after birth
SaO2 > 90%
2 pulse ox
avoid PPV
110
where are pulse ox placed CDH
pre-ductal: arm
post-ductal: foot
111
where is art line placed CDH
right upper extremity
112
low delta in pulse ox CDH
open PDA
113
high delta in pulse ox CDH
closed PDA
114
most common congenital anomaly of esophagus
esophageal atresia type C
115
esophageal atresia s+s
choking/aspiration
coughing
cyanosis
excessive salivation
116
VACTERL
(tracheoesophageal fistula)
Vertebral anomalies/VSD
Anorectal malformation
Cardiac anomalies
TEF
Esophageal atreasia
Renal abnormalities
Limb/radial malformation
117
TEF
fully developed respiratory system where esophagus connects to trachea
118
TEF B/D/E
upper esophagus connects to trachea
119
TEF C/D/E
acid from stomach goes into trachea
120
TEF management
spontaneous ventilation
121
omphalocele
bowel contained in sac
121
gastroschisis
bowel not contained in sac
122
gastroschisis fluid losses
100-200 mL/kg/hr
123
hirshprungs disease
aganglionic megacolon
stool buildup
124
pyloric stenosis causes
projectile vomiting
125
pyloric stenosis is a
medical emergency cannot get fluids in
126
volvulus
bowel obstruction that twists upon itself
127
volvulus is a
surgical emergency
causes sepsis if not treated
128
biliary atresia
inflammation of bile ducts causing obliteration of extrahepatic biliary tract
129
biliary atresia diagnosis
persistent jaundice
130
biliary atresia causes
cirrhosis
131
kasai procedure
surgical removal of blocked duct
anastamosis of small bowel onto intrahepatic bile duct
132
pts require what after kasai procedure
50% require liver transplant
133
pectus excavatum causes
restrictive lung disease
134
pectus excavatum PFTs
decr capacity
incr pressure
135
what corrects pectus excavatum
nuss procedure
136
necrotizing enterocolitis
life threatening intestinal inflammation or injury
bacterial infection to affected bowel
137
CP pts require
lower MAC
138
CP pts have ______ emergence
delayed
139
CP pts are sensitive to
precedex
140
vagal nerve stimulators are
turned off before surgery
141
hydrocephalus
CSF acumulation due to imbalance of CSF production/reabsorption
142
hydrocephalus prcedure
VP-shunt
143
spina bifida
fetal malformation with protrusion of spinal cord and meninges in spinal column defect
144
when is spina bifida treated
w/i 24 hrs of birth
145
spina bifid lifelong deficits
neurogenic bowel
neurogenic bladder
lower extremity sensory/motor loss
146
main concern during myelomeningocele repair
avoid compressure of defect during airway manipulation
147
cranyosynostosis
premature closure of cranial sutures
incr ICP
148
cranyosynsostosis pt posiitonin
sphynx
149
spinal muscular atrophy treatment
spinarza
zolgensma
150
what should you avoid in SMA
sux
caution with opiods and NMD
151
ped difficult airways
pierre-robin
goldenhar
treacher collins
apert syndrome
crouzon syndrome
beck with wiedemann
downs
freeman sheldon
klippel feil
pfeiffer
152
pierre robin triad
micrognathia
glossoptosis
airway obstruction
153
goldenhar
hemifacial microsomia
154
treacher collins
madibular dystosis
receding chin
155
apert
autosomal dominant
156
crouzon
craniofacial dystosis
malformation of face and skill
157
spica cast
used to imobilie one or both lower exrremities
158
most common genetic diseas in children
trisomy 21
159
trisomy 21
cardiac anomalies
OSA
hypotonia
ligamentum laxity
160
trisomy pts cannot
extend neck due to atlantoaxial instability
161
trisomy pts ETT
smaller glottic opening
0.5 smaller ETT
162
trisomy pts reaction on inhalational induction
bradycardic
