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Final Written > Paeds > Flashcards

Paeds Flashcards

1
Q

Circulating volume of neonate vs adults

A

Neonate 90ml/kg
Adults 70ml/kg

Prems can be up to 110ml/kg

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2
Q

Total body water neonates vs adults

A

Neonates 75-80%
Adults 60-65%

Neonates proportionately more ECF than adults

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3
Q

Apgar score

A

5 domains all score 0-2 points max score 10
Appearance, pulse, grimace, activity/tone, resp
Should be done at 1, 5 and 10mins if initial two low

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4
Q

Metabolic derangement in pyloric stenosis

A

Hypochloraemic hypokalemic hyponatremic metabolic alkalosis

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5
Q

Which way face ett bevel in TOF surgery

A

Face bevel away from fistula

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6
Q

When do apnoeic periods continue until

A

60 weeks post conceptual age (highest risk until 44 weeks)

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7
Q

Spinal cord and dura level in neonates vs adults

A

Spinal cord neonates l3 vs adults l1

Dura s3 adults s1

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8
Q

Features of meningococcal sepsis

A 
Non blanching rash 
CRT more than 2 
Reduced conscious level 
Toxic moribund state 
Unusual skin colour 
Shock 
Leg pain
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9
Q

Management of meningococcal sepsis

A 
Oxygen 
IV IO access 
Blood lactate and glucose 
Fluid bolus 20ml kg up to 60
IV antibiotic s ie ceftriaxone 50-80mg kg 
Consider intubation and ventilation 
Picu 
Vasopressors norad in warm shock adrenaline in cold shock
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10
Q

Specific investigations meningococcal septicaemia

A

Blood cultures
Lactate
CT
Coagulation

LP is controversial

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11
Q

Indications for intubation and ventilation in meningococcal septicaemia

A

Reduced conscious level
40ml kg consider and should be at 60
Increased ICP
Stabilisation prior to transfer

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12
Q

Physiological factors effecting gastric emptying

A

Increase gastric emptying

Large volume
Liquid
Sittin* position
Motulin gastrin

Reduce gastric emptying
High fat chyme 
Duodenal food bolus 
Somatostatin Cck 
Lateral position
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13
Q

Pharmacological factors effecting gastric emptying

A

Drugs increasing gastric emptying include
Erythomycin
Dopamine antagonists ie metoclopramide
Neostigmine

Drugs reduced gastric emptying
Opiates
Atropine and glyc

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14
Q

Patient factors effecting gastric emptying

A

Increased gastric emptying
Hyperthyroid

Reduced 
Stress 
Anxiety 
Pain 
Pregnancy
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15
Q

Effects prolonged fasting in children

A 
Unsettled child 
Parental anxiety 
Hypogylecema 
Ketoacidosis 
Hypotension 
PONV
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16
Q

Define cerebral palsy

A

Diverse group of neurological disorders resulting from brain injury or abnormalities antenatally or within first two years of life.

Result in varying degrees of motor sensory and intellectual impairment

17
Q

Clinical effects CP effects on anaesthetics

A

CNS consent and capacity
Communication re pain
Epilepsy
Usual auditory impairment

GI effects CP bulbar palsy reflux

Resp effects cp secretions restrictive lung defects pulmonary hypertension

Msg fixed flex ion deformities, heat loss low sc fat, poor muscle contraction resulting in bleeding

18
Q

Post op care cp

A

Good continuous analgesia
Physiotherapy
Active warming
CPAP

19
Q

Challenges re post op pain management in CP

A

Communication difficulties
Opiate sensitive
Interaction other drugs

20
Q

Scoliosis surgery aims

A

Cosmetic treatment of deformity
Prevention restrictive lung deficit
Correction of posture

21
Q

Cobbs angle

A

Angle between the two most angles vertebrae
More than ten degrees abnormal
Operate more tha 40 degrees

22
Q

Perioperative methods to reduce blood transfusion in scoliosis surgery

A 
Treat anaemia 
Treat coagulopathy
Hypotensive anaesthesia 
Surgical technique 
Tranexamic acid 
Cell salvage 
Minimise pressure on abdomen 
Monitor drains
23
Q

Option OLV sociologist surgery

A

Doubt lumen tubes
Bronchial blocker
Endobronchial intubation
Univent tube

24
Q

Neurophysiology in scoliosis surgery

A

Somatosensory evoked potentials- stimulus to posterior tibial never and picked up epidural or scalp electrode

Motor evoked potentials - transcranjal electrode stimulation of motor cortex and detected compound muscle action potentials

Intraoperative wake up test

25
Q

Analgesia for scoliosis

A 
Paracetamol 
Fentanyl 
Morphine
LA by surgeons e
Clonidine 
Ketamine
26
Q

Steroid doses if on steroids

A

2mg/kg

27
Q

Things to do if child on steroids or addisons

A

First on list
No starving more tha 6 hours.
Consider IV acc3ss and glucose
2mg/kg bolus then infusion

Extra Cade pituitary insufficient and those with DI as can end up with water intoxication

Final Written (12 decks)

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