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Peds Specialty Exam > Key Terms > Flashcards

Key Terms Flashcards

1
Q

What is the level of the vocal cords in children?

A

C4

Also level of cricoid cartilage

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2
Q

What electrolyte problems are associated with massive transfusion in children?

A

hypocalcemia

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3
Q

What are complications of GA for pts with Pierre-Robin syndrome?

A

difficult intubation

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4
Q

What is an important preop test for patients with Duchenne muscular dystrophy?

A

forced vital capacity < 30%, no surgery

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5
Q

What is the treatment for a distended abdomen during TEF repair?

A

no NG tube

no gastrostomy tube unless you can suction one and intermittently vent one that is already in place

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6
Q

Drug can than be safely given to MH susceptible pt.

A

propofol

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7
Q

What do you NOT do to treat laryngospasm?

lidocaine 1.5 mg/kg
jaw thrust
PPV
succx
100% O2

A

100% O2

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8
Q

What is normal respiratory deadspace in peds?

A

2 mL/kg

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9
Q

How do you maintain normothermia in children in the OR?

A

warm room

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10
Q

What are the NPO guidelines for a:

6 month old baby

A

clears 2-3 hours

solids, milks, formulas 6 hours

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11
Q

What is the peds dose for atropine?

A

0.01 mg/kg

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12
Q

What is the peds dose of Sux?

A

1.5 - 2 mg/kg (2mg/kg in neonates) IV

4 mg/kg IM

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13
Q

For emergency treatment of shock with large blood loss, what would be the best thing to give?

A

colloid 25%?

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14
Q

What are findings in congenital diaphragmatic hernia? (7)

A

scaphoid or sunken abdomen
respiratory failure with impingement on lungs
incidence 1:5000 births
pulmonary HTN
hypoplastic pulmonary artery
male:female 1:1
failure of pleuroperitoneal membrane to close

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15
Q

What are common electrolyte disturbances of premature infants?

A

hyperkalemia

hypernatremia

hypoglycemia?

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16
Q

What is the cause of greatest incidence of cardiac arrest in pediatric pts?

A

cardiovascular collapse

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17
Q

What is the treatment for post-intubation stridor?

A

racemic epi 0.25 - 0.5 mL of 2.25% solution in 2.5 mL

decadron for edema

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18
Q

When is the highest incidence of cardiac arrest in the pediatric population?

A

induction

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19
Q

What is the rate of inhalational induction of anesthesia in a 6-month old vs adult?

A

infant faster than neonate faster than adult because higher alveolar ventilation and low FRC

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20
Q

What is the anesthetic plan for infant with pyloric stenosis?

A

Not a medical emergency, correct electrolytes, and resuscitate with fluids

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21
Q

What factor is associated with closure of the ductus arteriosus in the newborn?

A

PVR drops

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22
Q

What must you consider with pt with trisomy 21?

A

Atlanto-occipital instability

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23
Q

What are normal vital signs for a full-term neonate?

A

HR: 100-140

systolic: 60-80

RR: 30-60

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24
Q

What is normal Hb for a neonate?

A

15 - 20

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25
Q

When is a neonate considered hypoglycemic?

A

< 30 g/dL

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26
Q

What is normal Na for a neonate?

A

140 - 160

27
Q

What is normal K for a neonate?

A

5 - 7.7

28
Q

What is normal Cl for a neonate?

A

93 - 112

29
Q

What is normal Ca for a neonate?

A

1.5 - 2.4 mmol/L

30
Q

What is normal pH in a neonate?

A

7.25 - 7.45

31
Q

What is normal paCO2 in a neonate?

A

35 - 50

32
Q

What is the principle determinant for diameter of an infant’s nasotracheal tube?

A

pinky

33
Q

How do you manage airway in a 2 year old pt with acute epiglotitis?

A

Mask down while sitting up, no NMB until tube is in

34
Q

What is management of 4 month old pt with recent URI scheduled for elective surgery?

A

proceed unless rhinorrhea or fever

35
Q

What is the most comon cause of GI obstruction in children?

A

pyloric stenosis

36
Q

What is systolic pressure in a full term neonate?

A

60 - 80

37
Q

How does adult Hb compare to fetal Hb oxygen dissociation?

A

fetal Hb has higher affinity for O2, shifted left = 19

Adult = 27

38
Q

What is considered neonatal bradycardia? What are causes?

A

< 100 bpm

drugs (sux), hypoxia, pain, hypothermia, cushing reflex

Main cause: hypoxemia

39
Q

What factor is associated with closure of patent ductus areriosus in newborn?

A

decreased PVR

40
Q

How do you treat oculocardiac reflex in peds?

A

ask surgeon to stop

41
Q

What factors produce reversion to fetal circulation in newborns?

A

high PVR

42
Q

What drug admixture is found in EMLA?

A

prilocaine and lidocaine

43
Q

What is normal HR and BP for a 2 month old?

A

HR 110 - 180

BP 70-85

44
Q

What is the IM dose of sux?

A

4-6 mg/kg

45
Q

How much fluid do you give in the first 24 hours for thermal burns in a peds pt?

A

4 ml/kg * % body burned

46
Q

How should you manage the airway of a trisomy 21 pt?

A

high vagal tone so can brady down quickly

downsize tube due to subglottic stenosis

47
Q

GA for pt with Downs for dental extraction?

A

nasal intubation

need c spine clearance

congenital heart defects

big tongue

GA for dental extraction for Downs syndrome patient. Inhalational induction oxymetazoline drops in both nares
graduated sizes of lubricated nasopharyngeal airways may be placed to help dilate the nares
place the nasotracheal tube in warm water
cuffed NETT should be used when possible.

48
Q

Initial settting for defibrillator for v-fib ped?

A

2 J/kg

49
Q

What amount of pressure is needed for air leak test for uncuffed ET in an intubated pt?

A

15 - 25 cm H2O

50
Q

What is infant glucose normally?

A

50 mg/dL

51
Q

At what O2 saturation is a premie safe at?

A

>85% ok because of retinopathy of prematurity with 100% O2

52
Q

When should you use caution using EMLA?

A

in <3 months old because of increased risk of metHb

53
Q

How do you calculate tube depth?

A

12 + age/2

54
Q

What size blade do you use for premies?

A

Miller 0,0 or Miller 0

55
Q

What is apnea of prematurity?

A

the more premature the baby is (born at an earlier postconceptual age) = the greater that baby’s risk is for postoperative apnea.

56
Q

After receiving an anesthetic, former premature infants should be admitted to the hospital overnight for cardio-respiratory monitoring for…

A

up to 52 weeks post-conceptual age

57
Q

For how long do you delay elective surgery for a premature baby to prevent apnea of prematurity?

A

46 weeks PCA

58
Q

When does the risk of post-op apnea of prematurity decline?

A

50 - 55 weeks PCA

59
Q

What should you do regarding post-op apnea risk premies?

A

consider giving caffeine

consider using unsupplemented regional anesthesia

60
Q

Where should the precordial stethoscope be placed?

A

suprasternal notch or chest

61
Q

How do you treat hypotension in tetralogy of fallot?

A

phenylephrine to increase LV pressure to turn R–> L shunt into L–> R shunt

62
Q

How is heat lost in anesthetized children?

A

Mostly lost during induction

Redistribution to periphery first

Radiation then Convection

63
Q

At what spinal level should caudal blocks be placed?

A

S4 - S5

64
Q

How do you manage unruly children in preop?

A

versed

ketamine 6-9 mg/kg PO, 5 mg/kg IM

fentanyl lollypop 10 -15 mcg/kg

rectal methohexital

Peds Specialty Exam (2 decks)

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