Hall Ch7 Flashcards

1
Q

Cricoid cartilage is at what cervical level in a newborn?

A

C4

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2
Q

Cricoid cartilage is at what cervical level in adults?

A

C6

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3
Q

Cricoid cartilage is at what cervical level in a 6 yr old?

A

C5

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4
Q

First sign of a high spinal in a patient under 5 yrs old

A

Hypoxia. Hypotension is rare in patients under age 5, this hemodynamic stability allows chance to start IV after spinal anesthesia is given.

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5
Q

Percentage of total body weight is water in term newborns

A

75%

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6
Q

Percentage of total body weight is water in premature newborns

A

80-85%

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7
Q

Anesthetic management for pt who is lethargic and no urine output for last 3 hrs and brought to OR for pylorus stenosis surgery

A

Postpone surgery until fluid resuscitated

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8
Q

Most common type of tracheoesophageal fistula

A

Esophageal atresia with lower segment of esophagus communicating with back of trachea

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9
Q

Volatile agent that sensitizes myocardium to catecholamines and causes dysthymias with inhalational induction

A

Halothane

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10
Q

Risk of retinopathy of prematurity is negligible after what post conceptual age?

A

44 weeks

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11
Q

Stage four of anesthesia

A

Respiratory paralysis, associated with respiratory and cardiovascular arrest

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12
Q

First stage of anesthesia

A

Analgesia. Responsive to verbal stimulation, intact lid and airway reflexes.

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13
Q

Rate of oxygen consumption in neonate

A

6 mL/kg/min

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14
Q

Previously healthy 5 yr old is in recovery room after GA, urine is dark brown, what does the pt need to be evaluated for?

A

Malignant hyperthermia

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15
Q

ETT leak for infant should be

A

15-25 cm H2O

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16
Q

Premature infant with congenital diaphragmatic hernia suddenly desaturates and bradys down after awake tracheal intubation, what’s next step?

A

Consider tension pneumo and place chest tube

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17
Q

Tube depth for 1 kg newborn

A

7 cm

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18
Q

Tube depth for 2 kg newborn

A

8 cm

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19
Q

Tube depth for 3 kg newborn

A

9 cm

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20
Q

Tube depth for typical 3.5 kg term newborn

A

10 cm

21
Q

Equation to estimate tube depth for children > 3 yrs old

A

Age/2 + 12
Or
Tube size * 3

22
Q

Omphalocele, imperforate anus, congenital diaphragmatic hernia, meningomyelocele and a tracheoesophageal fistula should have preop eval of what?

A

Eval of heart with echocardiogram

23
Q

Compared to adult dose, infant dose of succinylcholine should be?

A

Increased because of greater volume of distribution. 2 mg/kg instead of 1 mg/kg

24
Q

MCC of neonatal bradycardia

A

Hypoxemia

25
Q

What is the energy level for initial shock of defibrillator for children

A

2 J/kg, increasing to 4 J/kg for subsequent shocks

26
Q

Spinal cord of adults extend to what vertebral level

A

L1-L2

27
Q

Spinal cord of newborns extend to what vertebral level

A

L3

28
Q

MC initial symptom of esophageal atresia and TE fistula

A

Regurgitation and coughing with first feeding

29
Q

Beckwith-Wiedemann syndrome

A

Omphalocele, macrosomia, macroglossia, hypoglycemia, polycythemia, large fontanelles

30
Q

Estimated blood volume of healthy full term neonate

A

80-90 mL/kg

31
Q

Estimated blood volume of premature neonate

A

90-100 mL/kg

32
Q

Estimated blood volume of healthy 3-12 month old infant

A

75-80 mL/kg

33
Q

Pulmonary vascular resistance in newborns decreases to adult levels by what age?

A

2-3 months

34
Q

Patient after pyloric stenosis surgery can have CNS depression of ventilation because?

A

CSF alkalosis caused by metabolic alkalosis caused by emesis, worsened by intraop hyperventilation

35
Q

MAC for isoflurane and halothane is greatest at what age?

A

3 months old

36
Q

How much crystalloid should be administered in first 24 hrs after a burn injury?

A

4 mL/kg for each percent of body burned. Eg. 50% burn of 40 kg pt equals 4x40x50 = 8000 mL

37
Q

Preferred induction of GA in patient with cerebral palsy and severe GERD

A

Rapid sequence induction with succinylcholine. No reports of succinylcholine-induced hyperkalemia with cerebral palsy

38
Q

Fluid resuscitation for a patient with hypokalemia and is anuric for last few hrs

A

Isotonic crystalloid solution WITHOUT potassium, then add potassium once there is urine output

39
Q

Preterm infant making twitching movements

A

Hypocalcemia, preterm infants have very limited reserves. Dose would be 100-200 mg/kg of calcium gluconate every 6-8 hrs

40
Q

Why shouldn’t beta blockers be used to treat severe hypertension after phenylephrine is used by surgeons for sinus surgery

A

The severe peripheral vascular resistance shifts blood from periphery to increase preload. Beta blockers may lead to severe pulmonary edema and cardiac arrest. If beta blockers causes CHF to develop, consider using high dose glucagon (5-10 mg)

41
Q

The usual dose of bupivacaine for spinal anesthesia for infants usually lasts how long?

A

About 80 min

42
Q

GFR in newborns compared to adults

A

Lower

43
Q

Procedures with low incidence of PONV in children

A

Brief procedure with minimal pain

44
Q

Incidence of apnea and bradycardia spells in infants decrease significantly after what postconceptual age?

A

60 weeks

45
Q

Epidural technique with loss of resistance with air should be avoided in kids because?

A

Risk of venous air embolism

46
Q

Factors related to increased chance of SIDS (sudden infant death syndrome)

A

Low birth weight, maternal smoking, maternal cocaine use, low socioeconomic status, African-Americans, sleeping in prone position

47
Q

Chemo drug that inhibits plasma cholinesterases

A

Cyclophosphamide

48
Q

Chemo drug that is usually associated with pulmonary fibrosis

A

Bleomycin