Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

What are the traits of Epiglottis?

A

Organism: bacterial (H. Influenza, streptococci, pneumococci, staphylococci)
Age: 2-6 years
Onset: < 24 hours
Region affected: Supraglottic features (epiglottis, vallecula, arytenoids)
Neck X-RAY: thumb sign
Clinical presentation: fever, tripod position and the 4 Ds ~
> drooling
> Dyspnea
> dysphonia
> dysphasia
Treatment: oxygen and urgent airway tx
> tracheal intubation
> tracheostomy
> abx
> induction with SPONTANEOUS RR
> CPAP 10-15 to prevent airway collapse
>ENT SURGEON MUST BE PRESENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some traits with laryngotracheobronchitis (croup!)

A

Organism: viral (influenza, parainfluenza, resp syncytial virus)
Age: < 2
Onset: 24-72 hrs
Region affected: laryngeal structures BELOW vocal cords
X-RAY: steeple sign
Clinical presentation:
> low grade fever
> barking cough
> vocal hoarseness
> inspiratory stidor
> retractions
Treatment:
> oxygen
> racemic epi
> corticosteroids
> humidification
> fluids
> INTUBATION RARELY NEEDED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is postintubation croup?

A

Post-intubation laryngeal edema 😆~ complication of endotracheal intubation

> more common in small children
most common cause is using an ETT that is too large
other causes: rigid bronch, multiple intubation attempts

Usually presents 30-60 mins following extubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors for post-intubation laryngeal edema?

A

Age < 4
ETT too large
ETT cuff volume too high
Multiple intubation attempts
Prolonged intubation
Coughing
Head or neck surgery
Trisomy 21
Upper resp tract infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you prevent post intubation tracheal edema?

A

Maintain air leak < 25 cm H20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the preferred tx for post-intubation laryngeal edema?

A

Racemic epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the volume of racemic epi and volume of NS for a child weighing 0-25 kg?

A

Racemic epi: 0.25 mL
NS: 2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the volume of racemic epi and volume of NS for a child weighing 20-40 kg?

A

Racemic epi: 0.5 mL
NS: 2.5 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the volume of racemic epi and volume of NS for a child weighing > 40 kg?

A

Racemic epi: 0.75 mL
NS: 2.5 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long should a patient with post intubation laryngeal edema (post racemic epi) be monitored?

A

Min of 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the least to most stimulating airways?

A

Face mask > LMA&raquo_space;»> ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are reasons to allow surgery BUT proceed with caution?

A

Clear rhinorrhea (runny nose)
No fever
Active
Appears happy
Clear lungs
Older child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are reasons to CANCEL a peds surgery? (Think URI)

A

Purulent nasal discharge
Fever >38 / 100.4
Lethargic
Persistent cough
Poor appetite
Wheezing/rales
Child < 1 or previous preemie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long do most clinicians wait following a resp infection of a child before proceeding?

A

2-4 weeks AFTER onset of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How much does use of an ETT increase the risk of bronchospasm?

A

10-fold!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What dose of decadron will reduce the risk of post-intubation croup?

A

0.25-0.5 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the best inhaled anesthetic to reduce post-intubation croup?

A

Sevo. Less pungent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the classic triad of foreign body aspiration?

A

Wheezing, couch, decreased breath sounds on affected side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which side do children most commonly aspirate on?

A

Right.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does a supraglottic aspiration present?

A

Stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does a subglottic aspiration present?

A

Wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the GOLD standard to retrieve a foreign body?

A

Rigid Bronch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the best anesthetic for a child with an aspirated foreign body?

A

Sevo induction with spontaneous resps

> spontaneous resps should be used THROUGHOUT procedure ~ maintains laminae flow and reduces changes of distal movement of the foreign body
avoid positive pressure (push object further)
anesthesia circuit can be connected to rigid bronch ~ easy delivery of oxygen and volatile agent
may need to add TIVA d/t dilution (like a reg bronch) ~ best maintenance technique
avoid patient coughing or bucking (also moves object further)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the conditions with a large tongue?

A

Remember “Big Tongue”

B: beckwith syndrome
T: trisomy 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the conditions of a small/underdeveloped mandible?

A

“Please Get That Chin”

Pierre
Goldenhar
Treacher Collins
Cri du Chat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Cervical Spine Anomaly?

A

“Kids Try Gold”

Klippel-feil
Trisomy 21
Goldenhar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is Pierre Robin?

A

Small/underdeveloped mandible (micrognathia mandibular hypoplasia)

Tongue that falls backward
Cleft palate
***these neonates usually require intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is treacher collins?

A

Small mouth
Small underdeveloped mandible
Ocular and auricular anomalies

***Chonanal atresia ~ you won’t be able to pass a suction catheter part the point of the atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some traits of Down syndrome?

A

Small mouth
Large tongue
Atlantoaxial instability
Small subglottic diameter (subglottic stenosis)

30
Q

What are some traits about klippel-feil?

A

Congenital fusion of cervical vertebrae

Neck rigidity

31
Q

What is goldenhar?

A

Small underdeveloped mandible
Cervical spine abnormality

32
Q

What is beckwith syndrome?

A

Large tongue

33
Q

What is cri du chat?

A

Small underdeveloped mandible
Laryngomalacia
Stridor (probs r/t to ^)

34
Q

What are some airway considerations for cleft lip/palate?

A

Airway obstruction
Difficult laryngoscopy
Difficult mask
Aspiration

35
Q

What can reduce venous drainage and cause tongue enforcement during cleft lip/palate surgery?

A

Dingman-Dott mouth retractor

***increase risk of post-extubation airway obstruction

36
Q

What are some considerations for cleft lip/palate?

A

Failure to thrive (unable to generate enough negative pressure required for sucking)

37
Q

When is cleft lip repaired?

A

1 month of age

38
Q

When is cleft palate repair performed?

A

12 months of age

39
Q

What % of Down syndrome patients have a cardiac dx?

A

50%

40
Q

What is the most common cardiac dx associate with Down syndrome? What is the second

A

Atrioventricular septal defect ~ 1st!!!

VSD ~ 2nd

41
Q

What is the most common chromosomal disorder?

A

Down syndrome (trisomy 21)

Results from the addition of a 3rd copy of chromosome 21

42
Q

Why should a Down syndrome patient have a peds operative cervical spine X-ray before anesthesia?

A

Risk of atlantoaxial instability
> C1 and C2 subluxation ~ avoid neck FLEXION

43
Q

How does subglottic stenosis affect the anesthetic management for a Down syndrome patient?

A

Increased risk of death post-intubation croup

Smaller ETT!!!

44
Q

What is common during inhalation induction with a Down syndrome child?

A

Bradycardia!!

Tx is anticholinergic!

45
Q

What is CHARGE?

A

C: coloboma (a hole in one of the eye structures)
H: heart defects
A: atresia of the nasal passage
R: restriction of growth and develop.
G: genitourinary problems
E: ear anomalies

A pirate names COLOmbus who was in CHARGE of a small RESTRICTED (growth)ship, was sailing the seas. One day a seagull attacked his GENITALS….no one on board HEARD (due to ear anomalies) him scream. This gave his HEART (anomalies) a fright. Thank goodness he had NASAL ATRESIA because he couldn’t smell his poopy pants.

46
Q

What is Catch 22?

A

CATCH 22

C: cardiac defects
A: abnormal face
T: thymic hypoplasia
C: cleft palates
H: hypocalcemia
22: 22q11.2gene deletion

On day a chef named CARD B (cardiac anomalies) made the biggest CATCH of her life. She cause a ABNORMAL (face)looking fish, but thought it would be delish with a little THYME (thematic hypoplasia)! She served it on the Crystal Plates (cleft palate). But she forgot the glasses of MILK (hypocalcemia). Fortunately all 22 guests, including kind DiGeorge (also called DiGeorge) loved it!!!

47
Q

What type of electrolyte imbalance is common in DiGeorge syndrome?

A

Hypocalcemia!!’

48
Q

What is the child with DiGeorge at risk for if the thymus is absent?!

A

Infection!!!

Tx consists of thymus transplant or mature T cell infusion

49
Q

What type of transfusion product is best for DiGeorge?

A

Leukocyte-depleted irradiated blood

50
Q

What is the most common coagulation disorder in patients undergoing adenotonsillectomy?

A

Von Willebrand Dx

51
Q

What is the MOST common indication for adenotonsillectomy?

A

Upper airway obstruction and sleep disordered breathing.

52
Q

What is the other indication for adenotonsillectomy?

A

Chronic and/or recurrent infections (tonsillitis, pharyngotonsillitis, otitis media, etc…)

53
Q

What is the most common cause of OSA in kids?

A

Adenotonsillar hypertrophy

54
Q

children with OSA undergoing adenotonsillectoy…

A

Have longer emergence
Should receive lower opioid dose
Higher incidence of airway obstruction
**should be admitted for 23 hours ops
SHOULD NOT RECEIVE CODEINE FOR POST-OP PAIN

55
Q

What electroly disorder are patients who receive DDAVP at risk for?

A

Hyponatremia (it’s like ADH)

56
Q

What should you ensure is removed prior to extubation with a adenotonsillectomy?

A

Throat pack!!!

Also suction well

57
Q

Post-tonsillectomy is considered what?

A

Surgical emergency!

58
Q

When does primary bleeding following a tonsillectomy occur?

A

First 24 hours

(75% or post-tonsillectomies bleed within first 6 hours)

59
Q

When does secondary bleeding following a tonsillectomy occur?

A

5-10 days after tonsillectomy.

(Following scar -eschar- covering contacts ~ secondary bleeding)

60
Q

Why are patients with post-tonsillectomies nauseous?

A

They may have swallowed a lot of blood.

They should be RSI!!! (Surgeon needs to be present prior to induction)

61
Q

How does ongoing bleeding following post-tonsillectomy affect volume status/CO?

A

Reduces volume
Reduces CO
Reduce BP (> 20% loss is suggestive when dizziness and orthostatic hypotension are present) ~ need ongoing resuscitation.

62
Q

How should you oxygenate an active post-tonsil bleed?

A

Left lateral with head down

63
Q

What is defined at geriatric/elderly?

A

65 years and older

64
Q

What is the most significant risk factor for developing by cancer?

A

Getting old!

65
Q

What is one MET (metabolic equivalent) equal to?!

A

3.5 mL/O2/min

66
Q

For every 1 MET a patient can achieve, mortality decreases by what?

A

11%

67
Q

What are examples of 1 MET?

A

Self care activities
Working at a computer
Walking two blocks slowly

68
Q

What are examples of 4 METS?

A

Climbing a flight of stairs
Walking up a hill
Light housework
Raking leaving
Gardening

69
Q

What are examples of 10 METS or more?

A

Strenuous sports (running, swimming. Basketball)

70
Q

How is frailty defined?

A

Decreased reserve coupled with reduced resistance to stress.

Patients that are frail are more likely to suffer poor outcomes with perioperative stressors

Apex (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions