CCP S3 Flashcards
What is DKA?
Diabetic ketoacidosis
What is a peptide hormone produced in the pancreas?
Insulin
What is the definition of DKA?
Ketones in urine, metabolic acidosis, hyperglycemia
What is the best way to evaluate dehydration in DKA?
Capillary refill, abnormal skin turgor, abnormal respiration’s
Common paralytic dosages in pediatric
Roc 1 mg/kg
Succs 2 mg/kg
Ways to determine tube size in peds?
Broselow tape, width of nare, (age/4) +4, width of pinky finger
Ways to determine gestational age
First day of last menstrual period, ultrasound
What is EGA?
Estimated gestational age
What is IUGR?
Intrauterine growth restriction
What causes the onset of labour?
Unknown
What is the biggest risk factor of pre-term delivery?
Previous pre-term delivery
What is the easiest way to determine depth of ET tube insertion in a pediatric patient?
3 x size of ET tube
Ways to confirm ETT placement?
Chest rise, bilateral air entry, colourmetric ET, ETCO2, CXR, misting in tube, SpO2
Minimum blood pressure in peds?
70 + (age x2)
Goals of antihypertensive therapy in obstetrics
Reduce chance of maternal CVA, maximize maternal condition for transfer, gain time for maternal and fetal assessment
Common antihypertensives for maternity patients
Nifedipine, labetalol, hydralazine, magnesium sulfate
What is the diastolic blood pressure we consider leading to eclampsia?
DBP > 110
Pre-eclampsia >90
Dose of magnesium in maternal hypertension
4 g IV over 20 minutes
Signs and symptoms of magnesium toxicity
Depressed tone, depressed reflexes, decreased sensorium
What is a tetralogy of fallot?
Large VSD
Overriding aorta
Obstructive RVOT
RV hypertrophy
Dosing for sedation vs vasopressors
Sedation mcg/kg/hr
Vasopressors mcg/kg/min
What is CMV?
Continuous mandatory ventilation
What is HELLP syndrome?
Hemolysis,
Elevated Liver Enzymes
Low platelets
what are factors that will determine how well a preterm baby will progress post-delivery?
Gestational age Sex Weight Level of hospital Multiples Diabetic mother Maternal drug use Maternal ETOH, smoking, etc
Signs and symptoms of pediatric seizures
ALOC, twitiching eyes, arched back, clenched teeth, tachycardia, deviated eyes, tonic/clinic movements, muscle stiffness
Risk factors for pre-term delivery
Cervical incompetence Previous pre-term delivery Infection Multiples Placental insufficiency
RDS signs and symptoms
Nasal flaring In drawing Tachypnea Cyanosis Tracheal tug Grunting Apnea
Contraindications to tocolytics
Fetal death Non-reassuring strip Maternal illness Placental insufficency/abruption Severe preeclampsia Allergy Choriamnioniitis PPROM
Contraindications to fetal fibrinecten?
Vaginal exam in 24 hours
Sex in 24 hours
PROM
Presence of blood
TTN
Transient tacypnea of newborn.
Related to increased fetal fluid in airways (risk factors decreased GA and c section)
Tx is supplemental O2 if required, should resolve within 24 hrs
TEF
Tracheoespohageal fistula.
Sx excessive secretions, dyspnea from aspiration, poor feeding, unable to pass feeding tube more than 10-15 cm.
Bronchiolitis
Results from viral infection in peds < 2 years of age.
Tx supplemental oxygen, monitor fluid balance, intubation if necessary
BPD
Bronchopulmonary displasia
Disruption of lung development causes decreased number of alveoli and thickened distance between alveolar air and capillary causing hypoxemia.
DKA Tx
Fluid resus 10-20 ml/kg based on shock status over 30 mins
Correct K
Insulin after 1-2 hrs 0.05-0.1 U/kg/hr
Two bag method to maintain bg
CN 4, 5, 6, 7
Trochlear (H)
Trigeminal (touch)
Abducens (H)
Facial (expression)
TCA effects
Na = wide QRS K = QT prolonged Antihistamine = DLOC Anticholenergic = Alice Alpha receptor = vasodilation GABA receptor = seizures Serotonin + dopamine = antidepressant
Coagulation cascade
Intrinsic (aPTT):
12 - 11 - 9 (+8)
Extrinsic (PT):
TF - 7
Common:
10 (+5) - prothrombin - thrombin (2) - fibrinogen - fibrin (1)
CaO2
(1.34 x Hgb x SaO2) + (0.0031 x PaO2)
DO2
CaO2 x CO
RSI plan (peds)
Ketamine 0.5-1 mg/kg
Roc 1 mg/kg
Morphine maint 5-40 mcg/kg/hr
Midaz maint 30-360 mcg/kg/hr
