Pediatric Anesthesia

Question 1

Narrowest level is ______

Answer 1

Cricoid cartilage

Question 2

Epiglottis is _____ shaped and _____. The vocal cords are slanted ______

Answer 2

Omega; stiff
Anteriorly (difficult to pass ETT)

Question 3

How does the rib cage affect ventilation?

Answer 3

It is more horizontal, making ventilation mostly diaphragmatic

Question 4

Surfactant is produced at _____ weeks of gestation

Answer 4

26-28

Question 5

Neonate diaphragm and intercostals are low in ______ muscle fibers causing

Answer 5

Type 1; quick fatigue

Question 6

Peak pressures in healthy infant

Answer 6

15-20 cmH20

Question 7

IBW

Answer 7

< 8yrs kg= 2x age +9
> 8 yrs kg = 3x age

Question 8

LBW

Answer 8

= IBW + 1/3 (TBW + IBW)

Question 9

How to size ID for ETT

Answer 9

ID (mm) = age/4 + 3

Question 10

What does a difference b/w preductal (RUE) and postductal (lower extremity) SpO2 suggest?

Answer 10

Pulmonary HTN, a right-to-left cardiac shunt, and the return to fetal circulation via the PDA

Question 11

What cells produce surfactant? When?

Answer 11

Type 2 pneumocytes; B/w 22- 26 wks

Question 12

What are 6 risk factors for respiratory distress syndrome in neonates?

Answer 12

Low birth weight,
Low gestational age,
Barotrauma from positive pressure ventilation
Oxygen toxicity,
Endotracheal intubation,
Maternal diabetes

Question 13

Where does a congenital diaphragmatic hernia usually occur?

Answer 13

Through the foramen of Bochdalek

Question 14

In a neonate with CDH, peak inspiratory pressure should be kept below:

Answer 14

PIP < 25-30 cmH2O

Question 15

After diagnosis, how long is CDH repair normally delayed?

Answer 15

5-15 days

Question 16

What 3 physiologic conditions should be avoided in neonates with CDH?

Answer 16

Conditions that increase PVR: hypoxia, acidosis, hypothermia

Question 17

Omphalocele is a/w what?

Answer 17

Trisomy 21, cardiac defects, and Beckwith-Wiedemann syndrome

Question 18

Gastroschesis is a/w?

Answer 18

Prematurity

Question 19

What is a late sign of pyloric stenosis?

Answer 19

Metabolic acidosis

Question 20

Excessive vomiting leads to what 5 metabolic abnormalities?

Answer 20

Dehydration
Hyponatremia
Hypokalemia
Hypochloremia
Metabolic alkalosis

Question 21

What are 2 risk factors for necrotizing entercolitis?

Answer 21

Prematurity (<32 wks)
Low birth weight (<1500 g)

Question 22

NEC affects what region of bowel?

Answer 22

Terminal ileum & proximal colon

Question 23

How many joules do you use for cardiac defibrillation in a peds pt?

Answer 23

1st shock= 2 J/kg
2nd shock= 4 J/kg
Subsequent shocks= 4-10 J/kg