Pediatric Anesthesia

Question 1

_____ are the most common comorbidity in children who present for surgery.

Answer 1

Upper respiratory tract infection

Question 2

Pprimary cause of sleep apnea in children

Answer 2

Large adenoids and tonsils

Question 3

Maneuvers to facilitate tracheal intubation in children

Answer 3

A 25-degree head-up position and exaggerated sniffing position such that the tragus lies above a horizontal line through the sternal notch facilitates tracheal intubation

Question 4

Allergies and anaphylaxis during anesthesia in children are most commonly due to:

Answer 4

Latex in children

Question 5

Anatomical difference of infants with adults

1. Head (2)
2. Mouth (2)
3. Neck (5)
4. Tracheobronchial tree

Answer 5

Head

1. Large occiput
2. Obligate nose breathers

Mouth

1. Larger tongue
2. Edentulous

Neck

1. Larynx more cephalad (C3-C4)
2. Epiglottis (omega shaped)
3. Vocal cords caudally
4. Narrowest (cricoid ring)
5. Trachea shorter (4-5 cm)

Tracheobronchial tree

1. R mainstem (acute angle)
2. Turbulent gas flow

Question 6

The most common airway problem in infants and young children is upper airway obstruction due to:

Answer 6

Laryngomalacia

Question 7

Several disorders present primarily with dificult mask

anesthetics and ventilation while tracheal intubation is usually straightforward: (3)

Answer 7

1. Crouzon’s
2. Apert’s
3. Down syndrome

Question 8

Shorter trachea facilitates what complication?

Answer 8

Endobronchial intubation

Persistent hemoglobin desaturation (SaO2 <85%) should suggest an endobronchial intubation.

Question 9

A corollary of this relationship is that hypotension in the child with a normal or increased heart rate is due to?

Answer 9

Hypovolemia

Question 10

Oxygen consumption in the brain of children is? (mL/100gm/min)

Adult?

Answer 10

5. 5

3. 5

Question 11

Cerebral blood flow in?

1. 6 months to 3 years
2. Adult

Answer 11

1. 50 mL/min/100g

2. 70-110 mL/min/100 g

Question 12

Gastric juice is closer to neutral pH (pH 6) at birth and does not reach adult levels of acidity until?

Answer 12

3 years old

Question 13

Hence, the free fraction of medications such as lidocaine is greater in young infants than in older children because of the concentration of what protein?

Answer 13

a1 glycoprotein