Brainscape's Knowledge GenomeTM

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


See full index

Boards > Peds > Flashcards

Peds Flashcards

1
Q

When does renal tubular function equal that of an adult?

A

Renal tubular function achieves full concentrating ability at ~2 years old

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

What three kidney values are lower in neonates than adults?

A

GFR
Renal perfusion pressure
Diluting/concentrating ability

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

When does GFR improve to adult levels in the neonate?

A

GFR improves in the first few weeks of life, but isn’t fully mature until 8-24 months of life

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

Describe cyanotic shunt HD goals:

A

Maintain SVR
Decrease PVR
Increase preload
Maintain HR and contractility

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

Describe cyanotic shunt hd goals:

A

Avoid increased SVR
Avoid decreased PVR

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

Right to left shunt examples:

A

Tetralogy of Fallot
Truncus arteriosus
Transposition of the great vessels
Tricuspid displacement (Ebstein’s anomaly)

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

Epiglottitis vs Laryngotracheobronchitis: Organism

A

Bacterial vs viral

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

Epiglottis vs Laryngotracheobronchitis: Age

A

2-6 yrs vs < 2 yrs

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

Epiglottis vs Laryngotracheobronchitis: Onset

A

Rapid (<24 hours) vs Gradual (24-72 hours)

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

Epiglottis vs Laryngotracheobronchitis: Region affected

A

Supraglottic: epiglottis, vallecula, arytenoids, aryepiglottic folds

Laryngeal structures below vocal folds

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

Epiglottis vs Laryngotracheobronchitis: Neck X-ray

A

Swollen epiglottis (Thumb sign) with lateral X-ray

Subglottic narrowing (Steeple sign) with frontal X-ray

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

Epiglottis vs Laryngotracheobronchitis: Clinical Presentation

A

High grade fever
Tripod assisted breathing
4 D’s: drooling, dyspnea, dysphagia, dysphonia

Low-grade fever
Barking cough
Vocal hoarseness
Inspiratory stridor
Retractions (suprasternal, substernal, intercostal)

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

Epiglottis vs Laryngotracheobronchitis: Treatment

A

Oxygen
Urgent airway management: tracheal intubation or tracheostomy
Abx if bacterial
Induction with spontaneous respirations (CPAP 10-15 cmH2O to prevent airway collapse)
ENT MUST BE PRESENT

Oxygen
Racemic epinephrine
Corticosteroids
Humidification
Fluids
Intubation rarely required

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

Racemic epinephrine dosing

A

0-20 kg = 0.25 mL of 2.25% racemic epi in 2.5 mL of NS

20-40 kg = 0.5 mL of 2.25% racemic epi in 2..5 mL of NS

> 40 kg = 0.75 mL of 2.25% racemic epi in 2.5 mL of NS

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

Treatment for postintubation croup:

A

Racemic epi
Cool and humidified O2
Dexamethasone 0.25-0.5 mg/kg IV (max effect 4-6 hours)
Heliox - increased laminar flow
Is not infectious so abx not indicated

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

Airway risks in peds with URI:

A

increased airway reactivity (bronchospasm)
laryngospasm
mucous plugging in airway
atelectasis
desaturation events
postoperative hypoxemia

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

When to postpone elective surgery due to URI:

A

purulent nasal drainage
fever >38C or 100.4F
lethargic
persistent cough
poor appetite
wheezing and rales that don’t clear with cough
child <1 year or previous premie

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

When to proceed with elective surgery despite URI:

A

clear rhinorrhea
no fever
active
appears happy
clear lungs
older child

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

How long should you wait to anesthetize a child after URI?

A

2-4 post onset of symptoms
but
pulmonary complications can persist for up to 6-8 weeks

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

What medication can help prevent post-intubation croup?

A

Dexamethasone 0.25 - 0.5 mg/kg IV

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

Foreign body aspiration classic triad:

A

cough
wheezing
decreased breath sounds on affected side (usually the right)

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

What do you hear with supraglottic obstruction?

A

stridor

23
Q

What do you hear with subglottic obstruction?

A

wheezing

24
Q

Pneumonic for large tongue

A

Big Tongue

Beckwith sydrome
Trisomy 21

25
Q

Pneumonic for small/underdeveloped mandible

A

Please Get That Chin

Pierre Robin
Goldenhar
Treacher Collins
Cri du Chat

26
Q

Pneumonic for cervical spine anomaly

A

Kids Try Gold

Klippel-Feil
Trisomy 21
Goldenhar

27
Q

What characteristics contribute to the difficult airway of a Down Syndrome patient?

A

small mouth
large tongue
high arched and narrow palate
mid face hypoplasia
AO instability (C1 & C2 subluxation/avoid neck flexion)
subglottic stenosis (increased risk postintubation croup->use smaller ETT)
OSA
chronic pulmonary infection

28
Q

What CV affects accompany Down Syndrome?

A

AV septal defect (most common)
VSD (second most common)
bradycardia during sevo induction (tx=anticholinergic + increase sevo carefully)
low levels of circulating catecholamines

29
Q

VACTERL association

A

Vertebral defects
imperforated Anus
Cardiac anomalies
Tracheoesophageal fistula
Esophageal atresia
Renal dysplasia
Limb anomalies

30
Q

CHARGE association

A

Coloboma
Heart defects
choAnal Atresia
Restricted growth and development
GU problems
Ear anomalies

31
Q

CATCH 22 syndrome

A

Cardiac defects
Abnormal face
Thymus hypoplasia
Cleft palate
Hypocalcemia (due to hypoparathyroidism)
22q11.2 gene deletion

32
Q

When do post-tonsil bleeds usually occur?

A

Within the first 24 hours, usually within 6 hours

33
Q

When does post-tonsil bleeding usually occur in the healing stage and why?

A

5-10 postop when the scar (eschar) covering the tonsil bed contracts (secondary bleeding)

34
Q

What are dizziness and orthostatic hotn in a post-tonsil

A
35
Q

What are orthostatic hotn and dizziness indicative of in a post-tonsil bleed?

A

> /= 20% loss of circulating volume
give ongoing volume resuscitation before induction

36
Q

What position should you place a post-tonsil bleed in and why?

A

left-lateral, head down to drain blood away from the airway

37
Q

Describe METs

A

Bedside tool to assess functional reserve and measure perioperative risk.

1 MET = O2 consumption of 3.5 mL O2/kg/min

38
Q

What two questions can you ask to determine proceeding with surgery without cardiac workup?

A

Can you walk up a flight of stairs without stopping?
Are you able to walk four blocks without stopping?

39
Q

What does 1 METs mean? What activities correlate?

A

Poor functional capacity

Self-care activities
Working at a computer
Walking 2 blocks slowly

40
Q

What does 4 METs indicate? What activities correlate?

A

Good functional capacity

Climbing a flight of stairs without stopping
Walking up a hill (>1-2 blocks)
Light housework
Raking leaves
Gardening

41
Q

What does 10 METs correlate to? What activities does it include?

A

Outstanding functional capacity

Strenuous sports (running, swimming, basketball)

42
Q

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

A

11%

43
Q

What volumes and capacities increase in the elderly?

A

RV
FRC
CC

44
Q

What volumes and capacities decrease in the elderly?

A

ERV
VC

45
Q

What volumes and capacities remain unchanged in the elderly?

A

TLC

46
Q

What renal function remains the same in the elderly?

A

Serum creatinine

decreased GFR but also decreased muscle mass (less Cr produced) = no change

47
Q

What is the most sensitive indicator of renal function and drug clearance in the elderly?

A

Creatine clearance

48
Q

When does GFR decrease age wise and by how much?

A

Decreases 1 mL/min/year after age 40

49
Q

How much does MAC decrease in the adult?

A

6% every decade after age 40

50
Q

Why does perioperative hepatic function decrease?

A

Result from decreased liver blood flow and decreased liver mass
NOT due to impaired hepatocellular function (remains unchanged)

51
Q

Does alpha 1-acid glycoprotein production increase or decrease? What does that mean for drug reservoir?

A

Increases. Increased reservoir for basic drugs

52
Q

Does pseudocholinesterase increase or decrease in the elderly? What does this do to succinylcholine and ester LAs?

A

It decrease, leading to an increase in succinylcholine and ester LAs (more so in men than women)

53
Q

The aging process does not meaningfully affect which three processes:

A

Systolic function
Total lung capacity
Hepatocellular function

54
Q

Loss of lung elastic recoil in the elderly lead to what lung volume/capacity changes?

A

Increased dead space
Increased A-a gradient
Increased V/Q mismatch
Decreased alveolar surface area
Decreased PaO2

Boards (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions