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Anesthesia 101 > ITE Peds 3 > Flashcards

ITE Peds 3 Flashcards

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1
Q

In a neonate, how do you treat a tension pneumothorax?

A

22g blunt needle or angiocatheter inserted in ipsilateral second intercostal space at midclavicular line,

then insert ped thoracostomy tube

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2
Q

A newborn with a birth complicated by meconium has a __% chance of developing a PTX

A

10%

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3
Q

Cobb angle > __ degrees is indication for surgical intervention d/t worsening of pulmonary complications

A

40

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4
Q

How to intubate pts with halo cervical placement

A

intubate w/o ablating the pt’s ability to spontaneously breathe

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5
Q

Why are neonates predisposed to hypervolemia in setting of overly aggressive volume resuscitation?

A

immature kidneys excrete less water and electrolytes

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6
Q

Peds pt with

  • asymmetric face
  • one sided coloboma (hole in structure of eye)
  • ear tag
  • micrognathia
A

Goldenhar syndrome

- vascular accident affecting 1st and 2nd branchial arches

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7
Q

Peds pt with:

  • craniosynostosis (premature cranial suture ossification)
  • Hypertelorism (inc distance btwn orbits)
  • shallow orbits causing ocular proptosis
  • maxillary hypoplasia
  • Parrot-like beaked nose
  • NO micrognathia
A

Crouzon syndrome

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8
Q

Peds pt with:

  • Micrognathia
  • glossoptosis (displacement of tongue towards pharynx)
  • cleft palate
  • BILATERAL
  • does not involve ears and eyes
A

Pierre Robin Sequence

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9
Q

Peds pt with:

  • underdevelopment of bones of upper jaw
  • downslanting palpebral fissures
  • coloboma of lower eyelid
  • ear abnormalities
  • normal intelligence
A

Treacher collins

- more dysmorphic than robin or goldenhar pts

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10
Q

Peds pt with

  • intellectual disability
  • short stature
  • multiorgan involvement
  • abnl facies
  • abundant secretions
  • large tongue
  • short neck
A

Hurler syndrome

  • AR disorder
  • abnl a-L-iduronidase
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11
Q

5 congenital abnormalities (Goldenhar, Robin, Treacher collins, crouzon) are associated with OSA, ____ has been reported to be useful in all of them

A

Supraglottic airway devices (LMA)

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12
Q

Propofol infusion syndrome is assoc w/ ___ (4)

A
  1. rhabdomyolysis
  2. Lactic acidosis
  3. Renal failure
  4. cardiac failure
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13
Q

A newborn lung is (more/less) compliant compared to adults, and chest wall is (more/less) compliant

A

Lung - less

chest wall - more

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14
Q

MH complications (7)

A
  1. Rhabdo
  2. Myonecrosis
  3. renal failure
  4. hyperkalemia
  5. arrhythmias
  6. DIC
  7. Death
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15
Q

Early warning signs of MH

A
  1. tachycardia
  2. tachypnea
  3. inc ETCO2
  4. masseter muscle spasm
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16
Q

Postconceptual age definition

A

gestational age + age after birth

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17
Q

Postconceptual age of __ weeks correlates to < 1% postop apnea

A

56

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18
Q

______ is the strongest risk factor for post op apnea

A

prematurity

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19
Q

(Centrifugal/Roller) pump flow varies with changes in pump preload and afterload

A

centrifugal pump

20
Q

Roller and centrifugal pumps can deliver adequate systemic pressure during CPB periods via (pulsatile/non pulsatile) flow

A

non-pulsatile

21
Q

(Centrifugal/Roller) pump flow is essentially only dependent on the speed of the rollers

A

roller

22
Q

(Centrifugal/Roller) pumps have higher incidence of blood element destruction, creation of microemboli, and inflow/outflow obstructions

A

roller pumps

23
Q

(Centrifugal/Roller) pumps are preferred in cardiopulmonary bypass circuits

A

Centrifugal

24
Q 
Recite the normal values
CVP: 
PCWP: 
CI: 
SVR:
A

CVP: 2- 6 mmHg
PCWP: 6 - 12 mmHg
CI: 2.5 - 4 L/min/m2
SVR: 800-1200 dynes*sec/cm5

25
Q

All types of shock except ___ has lowered Cardiac output/index

A

septic

26
Q

Name that shock!

  • Decreased CVP
  • Decreased PAP (pressure after RH)
  • Increased PVR
  • Decreased LVEDP
  • Decreased CO
  • Increased SVR
A

Hypovolemic

27
Q

Name that shock!

  • Decreased SVR
  • Decreased CVP
  • Decreased PAP (pressure after RH)
  • Decreased PVR
  • Decreased LVEDP
  • Increased CO
A

Septic (Distributive shock/vasodilatory)

28
Q

Name that shock!

  • Increased LVEDP
  • Decreased CO
  • Increased SVR
  • Increased CVP
  • Increased PAP (pressure after RH)
  • Increased PVR
A

Cardiogenic

29
Q

Name that shock!

  • Increased PAP (pressure after RH)
  • Nothing PVR
  • Increased LVEDP
  • Decreased CO
  • Increased SVR
  • Increased CVP
A

Cardiac tamponade

30
Q

Name that shock!

  • Increased PVR
  • (-/decreased) LVEDP
  • Decreased CO
  • Increased SVR
  • Increased CVP
  • Increased PAP (pressure after RH)
A

Pulmonary embolism

31
Q

Name that shock!

  • Decreased CO
  • Decreased SVR
  • Decreased CVP
  • Decreased PAP (pressure after RH)
  • Decreased PVR
  • Decreased LVEDP
A

Neurogenic (Distributive/vasodilatory shock)

- dec CO is from spinal shock/bradycardia

32
Q

Initial landmark identified when performing lateral femoral cutaneous nerve block

A

anterior superior iliac spine

33
Q

Lateral femoral cutaneous nerve

  • provides sensory innervation to ____
  • derived from __ nerve roots
A

anterolateral thigh

L2-L3

34
Q

How do you perform a Lateral femoral cutaneous nerve block

A

1 cm medial and 1cm inferior to ASIS, where LFCN is located btwn sartorius and tensor fascia lata

35
Q

Condition where damage to LFCN leads to pain and paresthesias on the lateral upper thigh, which may extend to lateral knee

A

meralgia paresthetica

*LFCN can be entrapped btwn inguinal ligament and the ilium

36
Q

Which one allows passive expiration?
High frequency jet ventilation v
High frequency oscillatory ventilation

A

High frequency jet ventilation

- other wise auto-peep can develop

37
Q

Which one allows setting a specific tidal volume?
High frequency jet ventilation v
High frequency oscillatory ventilation

A

neither

38
Q

In both
High frequency jet ventilation and
High frequency oscillatory ventilation, CO2 removal is (directly/indirectly) proportional to frequency

A

inversely

- higher the frequency, the lower the amplitude (key to CO2 removal)

39
Q

____ most common valvulopathy associated with RA

A

Mitral valve disease

Aortic regurgitation

40
Q

Airway concerns in pts with RA (3)

A
  1. atlantoaxial subluxation
  2. TMJ synovitis limit mandibular motion
  3. Cricoarytenoid arthritis
    - hoarseness, pain on swallowing, post-extubation laryngeal obstruction
41
Q

Respiratory alkalosis results in (Hyper/Hypo) calcemia and (Hyper/Hypo)kalemia

A

Hypocalcemia
- Alkalosis –> H+ ions bound to negatively charged albumin is released to offset alkalosis –>
Ca2+ binds to albumin

*paresthesias can occur with hyperventilation

Hypokalemia
- H-K transporters pump H+ out of the cell and K+ intracellularly

42
Q

Wind up phenomenon is caused by repeated stimulation of ___ fibers, increasing action potentials at dorsal horn -> amplified response

A

C

43
Q

When should EPI be administered in non-shockable rhythms?

A

ASAP

44
Q

When should EPI be administered in shockable rhythms?

A

defib, then 2 min CPR then defib, then epi

45
Q

The foot is innervated by 5 nerves, but only 4 can be blocked at the ankle. Name them

A
  1. Posterior tibial
  2. Sural
  3. Superficial peroneal
  4. Deep peroneal
46
Q

Law that says that a change in gas volume is inversely related to pressure on the gas

A

boyle law

Anesthesia 101 (38 decks)

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