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Mar: Sem 6 - Adv. Principles B > Ped/OB Exam Review > Flashcards

Ped/OB Exam Review Flashcards

1
Q

Arnold-Chiari malformation may have what symptoms?

A

Recurrent Aspiration

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2
Q

Syndactyly, Cloverleaf Skull, Hypertolerism, and Midface Hyperplasia are characteristics of what syndrome?

A

Apert Syndrome

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3
Q

What induction drug should be avoided in Arnold-Chiari malformation surgery?

A

Ketamine (↑ ICP concerns)

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4
Q

Which Chiari malformation is most often associated with spinal bifida?

A

Type II (Arnold-Chiari)

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5
Q

Most common pediatric craniofacial defect

A

Cleft Palate

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6
Q

Anesthesia Intervention for Cleft Palate

A
  • Video Laryngoscopy
  • Dexemetomidine Infusion
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7
Q

Congenital Diaphragmatic Hernia is a defect that involves _________.

A

Hypoplastic Lung Tissue

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8
Q

What is the condition?

A

Gastroschisis

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9
Q

Indications for Craniofacial Surgery

A
  • Psychosocial Reasons
  • Severe Exopthalmus
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10
Q

Down Syndrome Anesthesia Induction Considerations

A
  • Post extubation stridor
  • Bradycardia
  • Potential Airway Obstruction
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11
Q

Intervention for the Following ETCO2

A
  • Increase FiO2 to 100%
  • Ask the surgeon to stop stimulating the patient
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12
Q

Anesthesia Considerations for Encephalocele

A

Challenging airway for the anesthesia provider.

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13
Q

Goldenhar Syndrome Characteristic

A
  • Cleft Palate
  • Mandibular Hypoplasia
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14
Q

Gastroschisis and Omphalocele surgical concerns for Anesthesia.

A
  • Monitoring signs of impeded venous return
  • Hypothermia
  • Hypovolemia
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15
Q

What is the congenital syndrome?

A

Meningocele

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16
Q

Anesthesia concern for bilateral microtia

A

Difficult airway

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17
Q

What is this causing?

A

Hypertrophied Pylorus Muscle

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18
Q

What does Pyloric Stenosis cause?

A

OUTLET obstruction

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19
Q

Crouzon Syndrome features

A
  • Midface hypoplasia
  • Proptosis
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20
Q

Inspiratory stridor and retraction at the suprasternal notch are symptoms associated with what?

A

Laryngospasm

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21
Q

If ETT luminal diameter decreases by 2 mm in a pediatric patient, what would be the increase in airway resistance?

A

32x increase in airway resistance

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22
Q

What is the syndrome?

A

Pierre Robin Syndrome

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23
Q

This syndrome requires a tongue suture to prevent glossoptosis in PACU.

A

Pierre Robin Syndrome

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24
Q

What acid-base balance is seen with Pyloric Stenosis?

A

Hypokalemic/ Hypochloremic Metabolic Alkalosis

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25
Q

Long-term complications seen from untreated Scoliosis

A
  • Decrease lung compliance
  • Recurrent Lung infections
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26
Q

What type of scoliosis is associated with cardiac and urological abnormalities along with hemifacial microsomia

A

Congenital Scoliosis

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27
Q

Spinal Bifida is a result of what?

A

Failure of fusion at the vertebral arches

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28
Q

Which Tracheoesophageal Fistula is the most common?

A

Type C (blind esophageal pouch and TE Fistula coming from the trachea)

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29
Q

The most common location for a Congenital Diaphragmatic Hernia

A

Left Posterior Lateral

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30
Q

The primary characteristic of Down Syndrome

A
  • Mandibular hypoplasia
  • Hypotonia
  • Subglottic Stenosis
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31
Q

Primary goal of managing pediatric airway with TE Fistula

A

Prevent aspiration pneumonitis

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32
Q

Three main characteristics involved with the Pierre Robin triad?

A
  • Glossoptosis
  • Micrognathia
  • Respiratory Distress
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33
Q

A higher dose of TXA would be considered for this surgical procedure

A

Neuromuscular Scoliosis Repair

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34
Q

The 3 C’s of TE Fistula

A
  • Coughing
  • Choking
  • Cyanosis
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35
Q

Anesthesia intervention for intraoperative bronchospasm

A
  • 100% FiO2
  • Deepening Anesthetic
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36
Q

Anesthesia consideration for myelomeningocele

A
  • Preservation of function
  • Avoidance of further injury
  • Proper position for intubation
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37
Q

Signs of Bronchospasm

A
  • Expiratory Polyphonic Wheezing
  • Slow upslope on the capnography monitor
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38
Q

Omphaloceles are associated with these anomalies

A
  • Congenital Heart Defects
  • Urologic Defects
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39
Q

_________ syndrome becomes more difficult to manage with age

_________ syndrome becomes easier to manage with age

A
  • Treacher Collins is more difficult with age
  • Pierre Robin is easier with age
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40
Q

Congenital Diaphragmatic Hernia Interventions

A

Small frequent tidal volumes

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41
Q

Calculate the appropriate tube size for a 6-year-old.

A

5.5 mm ETT

(6/4) + 4 = 5.5

42
Q

Calculate the appropriate tube size for a 10-year-old.

A

6.5 mm ETT

(10/4) + 4 = 6.5

43
Q

Large tongue, small mouth, and atlantooccipital instability associated with this syndrome

A

Down Syndrome

44
Q

Determine the ETT depth of a 10-year-old

A

17 cm

(10/2) + 12 = 17 cm

45
Q

Determine the ETT depth of a 4-year-old

A

14 cm

(4/2) + 12 = 14 cm

46
Q

The recommended dose of PO versed for pediatric patient

A

0.5 mg/kg

47
Q

Strabismus correction surgery is associated with these complications

A
  • N/V
  • Intraoperative bradycardia
  • Malignant Hyperthermia
48
Q

Which of the following is not recommended when securing an airway for epiglottis?

A

You do not want an IV induction (Keep the patient as calm as possible)

49
Q

The cricoid cartilage is the only ________ cartilage in the tracheal bronchial tree

A

Complete Ring

50
Q

The narrowest part of a child’s airway

A

Cricoid Ring

51
Q

What does VACTERL stand for?

A
  • Vertebral defects
  • Anal atresia
  • Cardiac defects
  • Tracheal anomalies
  • Esophageal fistula
  • Renal anomalies
  • Limb abnormalities.
52
Q

The 3 C’s of TE Fistula (repeat)

A
  • Coughing
  • Choking
  • Cyanosis
53
Q

Which common condition is associated w/ CDH?

A

Pulmonary Hypoplasia

54
Q

What would be the appropriate management method for a patient with suspected epiglottitis?

A

Administration of appropriate cephalosporins

55
Q

Which condition is not commonly associated with Trisomy 21

A

Hyperthyroidism

56
Q

Hemabate should be used with caution in which of the following comorbidities?

A

Reactive airway disease

57
Q

The most common cause of postpartum hemorrhage

A

Uterine atony

58
Q

Define placenta increta

A

The placenta has invaded the myometrium

59
Q

Which of the following is true of placental abruption?

A
  • Constriction of vessels will be impaired.
  • Chronic cocaine use is an increase risk factor
  • Uterus and abdomen are hypertonic and tender to the touch
60
Q

C-section patient on Mag. Which medication should be eliminated for general anesthesia?

A

Defasciculating dose of rocuronium

61
Q

Inverted uterus, what medication will relax the uterus?

A

Nitroglycerin

62
Q

Hallmark sign of placenta previa

A

Painless vaginal bleeding

63
Q

What are the benefits of ondansetron for amniotic embolism?

A
  • Mitigation of intense pulmonary vasoconstriction
  • Inhibition of initial platelet activation
  • Prevention of RV failure
64
Q

Uterine rupture is associated with what?

A
  • FHR < 110
  • TOLAC
  • Massive maternal hemorrhage
65
Q

The primary risk of placenta abruption.

A

Hypovolemic Shock

66
Q

The presence of ___________ indicates the patient has preeclampsia and not gestation hypertension

A

Proteinuria

67
Q

Initial symptoms of amniotic fluid embolism is a result of ___________

A

Pulmonary vasoconstriction

68
Q

Second-line treatment for boggy uterus after oxytocin

A

0.2 mg IM Methergine

69
Q

Characteristics of magnesium infusion

A
  • Acts on NMDA receptors to raise the seizure threshold
  • Patient will feel warm/flushed
  • Inhibits the release of ACh at the NMJ
  • Toxicity is treated with Ca Glugonate 1g
70
Q

Repeat C-sections are at risk for

A
  • Placenta previa
  • Gestation diabetes
  • Wound infection
  • Fetal malposition
71
Q

Pt with umbilical prolapse has an in situ epidural running 0.1% ropivacaine + fentanyl 1mcg/mL infusion at 10 mL/hr. The best option for managing this patient’s anesthetic for a C-section?

A

Give 2-chloroprocaine 3% (15 mL) + morphine preservative 2mg through the epidural

72
Q

Twin-to-twin transfusion syndrome is commonly associated with this type of placentation.

A

Dichoriontic Diamniotic

73
Q

The placenta attaching and invading the myometrium and adjacent organs is referred to as

A

Placenta Percreta

74
Q

A positive fetal fibronectin level is associated with

A

preterm labor

75
Q

Anesthesia conditions for external cephalic version

A
  • Admin Nitroglycerin
  • Prep OR for RSI
  • Preform analgesic spinal
76
Q

Preeclamptic patients is more likely to have

A
  • Thrombocytopenia
  • Increase SVR
  • Low oncotic pressure
  • Decrease fibrinogen levels
77
Q

Patient on propranolol, during epidural test dose, aspiration has blood. Explain failure for IV test dose.

A
  • Pre-existing adrenergic blockade blunted tachycardia of IV epinephrine
  • Pain of labor mask the change seen with the test dose
78
Q

HELLP syndrome, what is the rationale for the administration of corticosteroids?

A
  • Increase parturient plt count for C-section
  • Decrease intraventricular hemorrhage of the fetus after birth
79
Q

Maternal physiological change during preeclampsia

A
  • Decrease renal blood flow
  • Decrease hepatic blood flow
  • Increase cerebral blood flow
80
Q

The most common symptoms before eclamptic seizure

A
  • Headache
  • Visual disturbancess
81
Q

Mag Toxicity: what drug should be administered to treat this?

A

Calcium Gluconate

82
Q

Mag infusion, pt develops 3rd degree heart block. What is the best intervention for immediate resolution of the conduction defect?

A

IV Calcium Chloride

83
Q

Patient is 10cm dilated, baby is breeched, what drugs will relax the uterus to optimize delivery

A
  • Sevoflurane
  • Epidural Opioids
  • Pudendal Nerve Blocks
  • Nitrous Oxide Inhalation
84
Q

A woman undergoes general anesthesia C-section for preeclampsia. 2 hours post-op, the patient is still intubated, requiring mechanical ventilation, and cannot be aroused.

Deep Tendon Reflex 1+
MV, FiO2 0.4,
PaO2 130 mmHg
PaCO2 32 mmHg
pH = 7.45
BE = -0.6

What is the most likely cause?

A

Intercerebral Hemorrhage

85
Q

Amniotic Fluid Embolism: What is the least likely clinical finding?

A

Increase end-tidal CO2 tension

86
Q

TOLAC wants to try vaginal birth after 1 C-section, during delivery, experience a ruptured uterus. What is the likely cause of the uterine rupture?

A

Classic Uteral Incision

87
Q

Hypotension associated with Pitocin administration following C-section delivery of the fetus occurs from

A
  • The release of nitric oxide
  • The release of atrial natriuretic peptide
88
Q

Pt needs Methergine after a repeat C-section. Which receptor is the medication a partial agonist at?

A

Partial alpha-adrenergic receptor

89
Q

Maximum dose of Methergine

A

0.8 mg IM

90
Q

Epidural running 0.1 ropivacaine + fentanyl at 1 mcg/mL at 10 mL/hr. What is the best local anesthetic to use to convert this labor epidural to a surgery anesthetic?

A

Lidocaine 2%

91
Q

Which drug will relax the uterus for the doc to remove the placenta?

A

Nitroglycerin 50 mcg IV

92
Q

A 6-year-old (20 kg) girl develops pulseless v-tach after induction. What do you charge the defibrillator to?

A

40 J

2 J/kg

93
Q

Neonate presents with 3 days of vomiting; what electrolytes need to be corrected before surgery?

A
  • Chloride (hypochloremia)
  • Potassium (hypokalemia)
94
Q

A baby with gastroschisis is more likely than a baby with omphalocele to have this condition

A

Prematurity

95
Q

17 yr old develops pulmonary edema after post-op laryngospasm; while breathing at 100%, SpO2 is 80%. Which of the following is the most appropriate management?

A

PPV

96
Q

Sux does a comparison between infant/neonate and adult

A

The pediatric dose is increase to 2-3 mg/kg

97
Q

Goals of urine output to monitor volume status intra-operatively

A

0.5-1 mL/kg/hour

98
Q

What is the cardiac output increase in a mom delivering twins compared to a mom delivering one baby?

A

20% increase compared to a mom delivering a single baby

99
Q

Which pediatric patient is at risk for hypoglycemia?

A

Neonates

100
Q

The initial symptoms of umbilical cord prolapse is

A

Fetal bradycardia

Mar: Sem 6 - Adv. Principles B (14 decks)

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