Pediatric Disease

Question 1

What age kids have the greatest perianesthetic anxiety?

Answer 1

1-5 years

Question 2

What age is a neonate?

Answer 2

0-30 days

Question 3

What age is an infant?

Answer 3

1-12 months

Question 4

What age is a toddler?

Answer 4

1-3 year

Question 5

What age is achild?

Answer 5

4-12 years

Question 6

What age isa teen/adolescent?

Answer 6

13-19 years

Question 7

In pediatrics, the ____ has a higher position.

Answer 7

Larynx

Question 8

Why does airway obstruction occur more readily in the newborn and infant?

Answer 8

Larger tongue relative to oral cavity

Question 9

The anterior commissure in a newborn is slanted ____.

Answer 9

inferiorly

Question 10

What is the narrowest portion of the larynx in peds patients?

Answer 10

cricoid cartilage

Question 11

What is the narrowest portion of the larynx in adults?

Answer 11

vocal cords

Question 12

Do full term neonates or infants of 1-6 months age require lower concentrations of volaitles?

Answer 12

full term

Question 13

MAC steadily ___ until 2-3 months of age, but after 3 months, the MAC _____ with age.

Answer 13

increases

decreases

Question 14

What is the MAC of sevo in neonate and infants younger than 6 months?

Answer 14

3.2%

Question 15

What is the MAC of sevo in infants older than 6 months up to 12 years?

Answer 15

2.5%

Question 16

Neonates and infants require ____ dose of Sux than do older kids to produce similar degrees of block.

Answer 16

increased

Question 17

Why do neonates and infants require increased Suc dose?

Answer 17

increased ECF volume nad larger Vd

Question 18

When is Sux used most ofetn in kids?

Answer 18

RSI

Laryngospasm

Question 19

Uptake of inhaled anesthetic is ____ in infants than older kids.

Answer 19

more rapid

Question 20

Infants have a ____alveolar ventilation relative to FRC.

Answer 20

high

Question 21

Why is uptake of inhaled anesthetics mroe rapid in infants?

Answer 21

high alveolar ventilation relative to FRC

Question 22

Why do neonates have a potential increase of sensitivity to hypnotics?

Answer 22

immature BBB and decreased ability to metabolize drugs

Question 23

____ of many drugs is decreased in infants, which can result in high circulating concentrations.

Answer 23

protein binding

Question 24

What is classified as preterm newborn?

Answer 24

before 37 weeks

Question 25

What is an extremely low gestational age

Answer 25

23-27 weeks regardless of birth weight

Question 26

What leads to the development of neontatal respiratory distress syndrome (RDS)?

Answer 26

lack of appropriate type of surface-active material or surfactant

Question 27

What produces surfactant?

Answer 27

type II pneumocytes

Question 28

What does surfactant reduce?

Answer 28

alveolar surface tension

Question 29

How long does it take RDS to become apparent after birth?

Answer 29

within minutes

Question 30

What is the drug treatment of RDS?

Answer 30

administration of surfactant to preterm newborms

Question 31

What airway interventions are performed for RDS in preterm? (1st line)

Answer 31

nasal CPAP

Question 32

If CPAP fails to correct RDS in newborn, what is done next?

Answer 32

intubate and admin surfactant

Question 33

With sudden cardiorespiratory decompensation in the preterm newborn during hte intraoperative period, what is something that should be considered?

Answer 33

pneumo from barotrauma

Question 34

What should a preterm's Hct be maintained at to optimize systemic O2 delivery?

Answer 34

40%

Question 35

Colloids are preferred over crystalloids in preterm infants. T/F

Answer 35

true

Question 36

What is bronchopulmonary dysplasia (BPD)?

Answer 36

chrnoic lung dx in infancy

Question 37

Preterm infants likley to develop BPD are born during the _____ phase of lung development at ____ weeks.

Answer 37

canalicular | 24-26 weeks

Question 38

What factors play a role in development of BPD?

Answer 38

``` PPV High O2 Inflammation Pulmonary edema/pulmonary air leak poor nutrition airway hyperreactivity adrenal insufficiency meconium aspiratoin PNA CHF ```

Question 39

BPD is a clinical diagnosis as O2 dependence at ____ weeks post conceptural age or O2 requirements beyong _____ of life in infants w/ birth weight of _____.

Answer 39

36 weeks 28 days less than 1500 g

Question 40

What is the goal of treatment of BPD in preterm newborns?

Answer 40

maintain PAO2 >55 | Sat > 94%

Question 41

For BPD, maintenance of adequate oxygenation is necessary to prevent or treat ____ adn to promote lung tissue growth and remodeling of pulmonary vascular bed.

Answer 41

cor pulmonale

Question 42

In preterm newborns/kids with a history of mechanical ventilation, an ETT of what size should be chosen?

Answer 42

1-0.5 sizes smaller

Question 43

Why do you need to decrease ETT size in kids/neonates with hx mechanical ventilation?

Answer 43

b/c subglottic stenosis may be present

Question 44

Why should you establish deep plane of anesthesia in preterm newborn?

Answer 44

airway hyperreactivity is likley

Question 45

BPD - adequate O2 should be delivered to maintain a PAO2 of ____

Answer 45

50-70