Board Review

Question 1

What is the most common cause of SVT in children?

Answer 1

WPW (10-20%)

Question 2

Under what age should percutaneous needle crichothyrotomy be used in the difficult airway?

Answer 2

10-12

Question 3

What is the basic procedure for a percutaneous needle crichothyrotomy?

Answer 3

14 gauge angiocathether. Lower edge of crich membrane. Pointed towards feet at 45° angle.

Can connect with a 3 ml syringe barrel and then 7-0 ett connector.

Or connect a 10 ml syringe barrel and then insert a 7-0 tube and inflate the cuff.

Question 4

Why is a needle crich (percutaneous crich) and bag ventilation not used?

Answer 4

It actually leads to worse ventilation than jet ventilation.

Question 5

What is the appropriate I:E ratio for a pediatric patient with a needle crich on jet ventilation?

Answer 5

1:4

Question 6

What is jet ventilation contraindicated in patients less than 5 years old?

Answer 6

The risk of barotrauma is too high.

Question 7

What anaphylaxis like reaction can be caused by dark meat fish?

Answer 7

Scombroidosis

Question 8

What is the pathophysiology of scombroidosis?

Answer 8

High histadine content in spoiled fish is turned into histamine and patients have a histamine-mediated reaction

Question 9

What is the treatment of choice for scombroidosis?

Answer 9

Benadryl

Question 10

What is Heyde’s Syndrome?

Answer 10

Aortic stenosis and GI bleeding from GI angiodysplasia (not sure how these are related)

Question 11

Do all dog bites need antibiotics?

Answer 11

Technically no. Lower risk like simple lacerations on non-high risk areas (not on hands/feet/genitalia) without extensive damage and crush injury are likely find without antibiotics.

Additionally, primary closure does not significantly increase risk of infection in these patients.

Question 12

What clinical symptoms are ingestion of caustic agent are most sensitive and specific for significant injury?

Answer 12

Drooling, dysphagia, and stridor