Part 4: Pediatric anesthesia: overview

Question 1

A new born’s spinal cord ends at _____ body and the sac ends at _____.

Answer 1

• L3-4

- S3-4

Question 2

The 1 year old spinal cord ends at _____ body and the sac ends at _____.

Answer 2

• L1-2

- S1-2

Question 3

An epidural/caudal is for what type of surgery?

Answer 3

• T10 or lower surgery

- quickest to epidural space

Question 4

What are things to consider for pain management of a neonate?

Answer 4

• Metabolism (Liver) and GFR (Kidney) both decreased
• Volume of distribution is increased (ECF)
• Increase in unbound drug

Question 5

What are the S/S of malignant hyperthermia?

Answer 5

• tachycardia
• tachypnea
• hypoxia
• hypercarbia,
• acidosis
• rigidity
• PATIENT MAY PRESENT WITH UNEXPLAINED MYOGLOBINURIA (dark urine) POST OP

Question 6

T/F: Outpatient surgery on less than 60 week post conceptual premies is recommended.

Answer 6

FALSE (These premies are at risk for APNEA)

Question 7

T/F: Premies have a low MAC value.

Answer 7

TRUE

Question 8

An overdose of inhalation agent has what affect on the pediatric patient?

Answer 8

• bradycardia
• hypotension
• hypoxemia
• bradypnea

Question 9

What is EMLA cream made of?

Answer 9

• lidocaine

- prilocaine

Question 10

There are ___ umbilical artery(ies) and ___ vein(s).

Answer 10

• 2 artery

- 1 veins

Question 11

T/F: Strabismus surgery has an high incidence of PONV.

Answer 11

TRUE

Question 12

What are some conditions associated with Congenital Heart Disease.

Answer 12

• TEF
• Omphalocele
• Imperforate anus
• Down’s (Trisomy 21)

Question 13

T/F: High spinal often presents as hypoxemia.

Answer 13

TRUE

Question 14

T/F: Ketamine is the preferred pharmacological agent to use when an increase in PA pressure can cause in R>L and hypoxemia.

Answer 14

FALSE

Question 15

T/F: It is okay to use ketamine when there is a Right to Left shunt.

Answer 15

False

Question 16

T/F: Neonate blood volume is 80 cc/kg

Answer 16

TRUE

Question 17

T/F: Pyloric stenosis is associated with central respiratory depression vs mechanical depression in TEF, omphalocele and diaphragmatic hernia; gastroschisis.

Answer 17

TRUE

Question 18

T/F: Pulmonary vasculature resistance decreases rapidly at birth but is not at adult levels for about 2 years of age.

Answer 18

FALSE (….1 year of age)

Question 19

T/F: Twitchy neonates often need Calcium.

Answer 19

TRUE

Question 20

T/F: Pediatric patients have less risk than adults for MH.

Answer 20

FALSE

Question 21

T/F: An overdose on inhalation agents will cause tachycardia on a child.

Answer 21

FALSE

Question 22

T/F: Anemia on a child is lowest at 3 month of age.

Answer 22

TRUE

Question 23

T/F: Peripheral vascular resistance increased in utero then decreases at birth, and finally approaches adult levels at 1 year of age.

Answer 23

TRUE

Question 24

T/F: Monitoring twitches on a child is better noticed in their arms and diaphragm.

Answer 24

TRUE

Question 25

T/F: The parasympathetic is mature at birth, but the sympathetic is immature.

Answer 25

TRUE

Question 26

What is the reversal drugs and dose for muscle relaxers?

Answer 26

Neostigmine 0.05-0.06 mg/kg

Atropine 0.02 mg/kg