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Co-Exisiting Disease 2 > Peds > Flashcards

Peds Flashcards

1
Q

Neonate age?

A

<30 days

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2
Q

Infant age?

A

1-12 months

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3
Q

Child age?

A

1-12 years

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4
Q

Key differences between adult and peds airways:

Tongue, larynx, epiglottis, trachea and neck?

A
  • tongue is larger
  • more anterior and cephalad larynx
  • long, sometimes floppy epiglottis
  • short trachea and neck
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5
Q

What is the narrowest part in peds airway?

A

Subglottic region at the cricoid cartilage

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6
Q

What is the optimal airway potency for resuscitation?

A

Slightly extended (sniff position)

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7
Q

Infant lungs versus adult?

A

Stiff lungs

  • lower FRC
  • lower closing volume
  • lower lung compliance (small alveoli)
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8
Q

Infant chest wall compliance versus adult?

A

Greater compliance

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9
Q

Infant O2 requirement versus adult?

A

2x (6ml/kg)

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10
Q

Infant CO2 production versus adult?

A

2x (ml/kg)

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11
Q

Newborn CO?

A

4ml/beat

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12
Q

Infants baroreceptor reflex?

A

Immature

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13
Q

What is the main determinant of CO up to age 2?

A

HR

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14
Q

Renal function at birth (4)

A
  1. Decrease GFR
  2. Decrease Na excretion
  3. Decrease concentrating ability
  4. Retain water
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15
Q

Normal function of renal at what age?

A

6 months

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16
Q

Adult function of renal at what age?

A

2 years

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17
Q

GI function (3)

A
  1. Prolonged gastric emptying
  2. Incompetent lower esophageal sphincter
  3. Increase GERD
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18
Q

Which hepatic phase is: toxins are altered oxidation, reduction, isomerization, and hydrolysis?

A

Phase 1

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19
Q

Which hepatic phase is: more water soluble and attach to carrier molecules to be transported out?

A

Phase 2

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20
Q

What is most important is hepatic phase 1?

A

P-450: endoplasmic reticulum of liver tissues

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21
Q

When does hepatic phase 2 mature?

A

Not mature for more than 2 weeks

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22
Q

If phase 1 is too rapid compared to phase 2, it can cause what?

A

Excess free radical activity

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23
Q

Normal hematocrit for full term?

A

55%

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24
Q

Normal hematocrit for 3 months?

A

30%

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25
Q

Normal hematocrit for 6 months?

A

35%

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26
Q

3 options for preop meds?

A

Versed
Clonidine
Ketamine

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27
Q

Versed oral dosage?

A

.5mg/kg

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28
Q

Mechanism for clonidine?

A

Alpha 2 adrenergic agonist

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29
Q

Clonidine intranasal, IM and oral dosage?

A

Intranasal: 2-4 mcg/kg
IM: 2mcg/kg
Oral: 4-5 mcg/kg

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30
Q

IM ketamine dosage?

A

3-4mg/kg (up to 10)

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31
Q

Versed or clonidine have faster onset?

A

Versed

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32
Q

Versed or clonidine level of sedation?

A

Clonidine better

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33
Q

Increased emergence agitation with versed or clonidine?

A

Versed

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34
Q

Chest wall rigidity may occur with what in neonates and infants?

A

Small doses of fent and other synthetic opioids

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35
Q

Chest wall rigidity results in what?

A

Hypercarbia and hypoxemia

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36
Q

Clear liquids NPO?

A

2 hrs

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37
Q

Breast milk NPO?

A

4 hrs

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38
Q

Formula, non human milk NPO?

A

6 hrs

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39
Q

Premature neonates avg blood volume?

A

95 ml/kg

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40
Q

Full term neonates avg blood volumes?

A

85 ml/kg

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41
Q

Infants avg blood volumes?

A

80 ml/kg

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42
Q

Adult men avg blood volumes?

A

75 ml/kg

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43
Q

Adult women avg blood volume?

A

65 ml/kg

44
Q

Allowable blood loss equation?

A

ABL=[EBV x (Hi - Hf)]/ Hi

45
Q

2 peds IV line access?

A

Saphenous and “love” vein

46
Q

How long does EMLA cream need to work?

A

At least 1 hr

47
Q

Gauge size IV?

A

22, 24

48
Q

Drugs needed for peds set up? (3)

A

Sux, atropine, epi

49
Q

LMA size for neonate/infant up to 5 kg?

A

1

50
Q

LMA size for infants 5-10kg?

A

1.5

51
Q

LMA size for infants/children 10-20 kg?

A

2

52
Q

LMA size for children 20-30kg?

A

2.5

53
Q

LMA size for children/small adults over 30 kg?

A

3

54
Q

ETT size for neonate/infants up to 5kg?

A

3.5

55
Q

ETT size for infants 5-10kg?

A

4

56
Q

ETT size for infants/children 10-20kg?

A

4.5

57
Q

ETT size for children 20-30 kg?

A

5

58
Q

ETT size for children/small adults over 30 kg?

A

6

59
Q

Max cuff volume for neonate/infant up to 5 kg?

A

4

60
Q

Max cuff volume for infants 5-10kg?

A

7

61
Q

Max cuff volume for infants/children 10-20kg?

A

10

62
Q

Max cuff volume for children 20-30kg?

A

14

63
Q

Max cuff volume for children/small adults over 30 kg?

A

20

64
Q

Max cuff volume for normal and large adolescents/adults?

A

30

65
Q

Airway resistance equation?

A

(8nl)/(pie x r^4)

66
Q

ETT size for preterm infants?

A

2

67
Q

ETT size for 1000g infant?

A

2.5

68
Q

ETT size for 1000-2500g?

A

3

69
Q

ETT size for neonate-6months?

A

3-3.5

70
Q

ETT size for 6months-1 yr?

A

3.5-4

71
Q

ETT size for 1-2 years?

A

4-5

72
Q

ETT equation for beyond 2 yrs?

A

(Age in years +16)/4

73
Q

Optimal size unruffled ETT allows adequate ventilation but leaks about how much of water pressure?

A

20-25

74
Q

By what age does anatomy changes and become more adult like? (Triangular vocal cord opening becomes smallest diameter)

A

8 years

75
Q

If there is a break in the pressure seal, such as leak around ETT, then ventilation may be inadequate why?

A

Air takes the path of least resistance back out the mouth, rather than inflating the lungs

76
Q

Can peds pt potentially aspirate around an uncuffed ETT?

A

Yes

77
Q

Pierre-Robin syndrome patients present with (3)

A
  1. Cleft palate

2. Small face and glottis

78
Q

Is Pierre-robin syndrome easy to intubate?

A

No, very difficult (awake intubation)

-fully awake before extubation

79
Q

Treacher Collins syndrome presents with (3)

A
  1. Downward slanting eyes
  2. Micrognathia (small lower jaw)
  3. Malformed or absent ears
80
Q

3 muscle relaxants able to be used in peds?

A
  1. Roc
  2. Sux
  3. Vecuronium
81
Q

Neonat: RR, HR, BP

A

RR: 40
HR: 140
BP: 65/40

82
Q

12month: RR, HR, BP?

A

RR: 30
HR: 120
BP: 95/60

83
Q

3 yrs: RR, HR, BP?

A

RR: 25
HR: 100
BP: 100-70

84
Q

12 yrs: RR, HR, BP?

A

RR: 20
HR: 80
BP: 110/60

85
Q

What are the 3 treatments for layrngoaspam?

A
  1. Constant positive pressure
  2. Propofol
  3. Sux with atropine IV or IM
86
Q

2 treatments for post-intubation croup?

A
  1. Racemic epi

2. Humidified mist

87
Q

Rating scale for pain used in peds?

A

Wong-baker faces

88
Q

What is the FLACC pain scale acrimony stand for?

A 
Face 
Legs 
Activity 
Cry 
Consolability
89
Q

Approximate time to 0 O2 sat from inspired concentration of 90% for 10kg child?

A

4min

90
Q

What 2 things contribute to more rapid hypoxemia?

A
  1. Increased metabolic rate

2. Decreased FRC

91
Q

Dose of Tylenol for neonates, infants, and children?

A

PO 10-15 mg/kg

92
Q

Max Tylenol for neonates?

A

60 mg/kg/day

93
Q

Max Tylenol for infants/children?

A

75 mg/kg/day

94
Q

Dose for sacral lumbar level block (penile/lower extremity?

A

.5-.7 ml/kg

95
Q

Dose for lumbar thoracic level block (lower abdominal)?

A

1 ml/kg

96
Q

Dose for upper thoracic level block (upper abdominal)?

A

1.2 ml/kg

97
Q

End of spinal cord and dural sac for neonate?

A

L3 and S4

98
Q

End of spinal cord and dural sac for 1 yr?

A

L1 and S2

99
Q

End of spinal cord and dural sac for adult?

A

L1 and S2

100
Q

For spinal dosing with tetracaince, use of Epi wash can increase during up to how long?

A

120 min

101
Q

Acute epiglottis is rarely seen now due to what vaccine?

A

H influenza type B vaccine

102
Q

Pyloric stenosis is more common in male or female?

A

Male (4:1)

103
Q

Pyloric stenosis symptoms are apparent between?

A

2-6 wk of life

104
Q

3 physical exam signs for pyloric stenosis?

A
  1. Visible gastric peristalsis
  2. Palpable “olive shaped” mass or the right of the epigastric area
  3. Dehydration
105
Q

5 common metabolic abnormalities for pyloric stenosis?

A
  1. Hyponatremia
  2. Hypochloremia
  3. Hypokalemia
  4. Primary metabolic alkalosis
  5. Compensatory respiratory acidosis
106
Q

3 anesthesia concerns with pyloric stenosis?

A
  1. Pulmonary aspiration
  2. Severe dehydration
  3. Metabolic acidosis

Co-Exisiting Disease 2 (11 decks)

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