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Coexisting Diseases > PEDS > Flashcards

PEDS Flashcards

1
Q

Fetal to neonatal physiology transition takes place in _______________

A

the first 24-72hours (delay surgery if possible)

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2
Q

Avoid ________ and __________ so PDA does not reopen in the neonate

A

hypoxia and acidosis

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3
Q

The baby modulates Cardiac Output by …….

A

Changing HR

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4
Q

The baby has a ______________________ which gives them limited ability to handle fluid load or increase in SV

A

Noncompliant LV

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5
Q

Infants have limited ____________ and have a very mature ___________ system

A

catecholamine stores

PSNS

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6
Q

Neonates consume how much more O2 than adults?

A

double

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7
Q

The normal systolic BP in an infant is _____… neonate ______ …. 5yrs of age ______

A

95
65
95

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8
Q

The normal heart rate in a neonate is _____

A

130

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9
Q

RESP: Infants have the same _______ & _______ as adults but differ in ________

A

TV & Dead space

RR (theirs is 2-3x higher)

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10
Q

RESP: Infants have decreased _________ muscle fibers in their diaphragm

A

Type I (they have less “marathon” muscle)

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11
Q

RESP: Infants have a smaller number of ________ in their lung until around age 8.

A

alveoli

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12
Q

The infant and neonate’s O2 consumption is _____ml/kg/min. Pediatric o2 consumption is __-__ ml/kg/min

A

5-6

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13
Q

_________ & __________ DEPRESS ventilation

A

hypoxia and hypercapnia

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14
Q

Describe lung compliance and chest wall compliance in the infant vs adult

A

adult - good lung compliance and non-compliant chest wall

PEDS - decreased lung compliance and compliant chest wall

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15
Q

The FRC in the neonate is _____ compared to _______ mL/kg in the adult

A

25

40

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16
Q

Do infants breath more from the nares or mouth?

A

Obligate Nasal breathing

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17
Q

____________ is the Narrowest park of the pediatric airway. It is at the level of C_-C_

A

cricoid cartilage

C2-C3

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18
Q

What position is ideal for intubation of the very young child?

A

neutral or slightly flexed

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19
Q

ECF in a neonates is ______% of their body weight and ____% of body weight by age 2

A

40

20

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20
Q

The baby will have normal kidney function by age ___________

A

6 months

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21
Q

The normal hog at birth is between ___-___ g/dL and at 2 months is ____-____. A newborn blood loss >___% may not be tolerated d/t FETAL hbg.

A

18-20
10-12
10-15%

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22
Q

Describe the glucose metabolism in infants:

A

minimal glycogen stores

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23
Q

Coordination of swallowing and breathing is not mature until ___-___ months

A

4-5

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24
Q

Plasma albumin levels are _____ in term newborns

A

low

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25
Q

Babies control thermoregulation using __________________

A

brown fat metabolism

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26
Q

The E1/2t in infants is ____________ for most drugs and it is _____________ for children 2-12years

A

prolonged

shortened

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27
Q

Will the infant have a large or small Vd with H2O soluble drugs?

A

Large

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28
Q

A _________ blade is more optimal for intubation

A

Miller

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29
Q

MAC values for an infant are _________ compared to adults

A

1/3 higher

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30
Q

MAC values lowest to highest from preemie to adult are?

A 
preemie
adult
child
neonate
infant
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31
Q

The speed of inhalational induction is faster in PEDS d/t what 2 main factors?

A

High minute ventilation and LOW FRC

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32
Q

The doses of IV induction agents for PEDS are…….

A

on the adult high end of dosing

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33
Q

The normal dose of propofol in a 1 year old is _____mg/kg IV

A

3

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34
Q

The normal dose of propofol for a 6 year old is _____ mg/kg

A

2

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35
Q

We want to avoid using morphine in young babies because …….

A

they have a very immature/permeable BBB… it is easier to overdose

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36
Q

Fentanyl is most common in PEDS and the dose is ____-___ mcg/kg

A

.5-1.0

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37
Q

Succinylcholine can cause _____________ in PEDS. You must mix it with ______________

A

profound bradycardia

atropine

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38
Q

The normal dose of Sch in children is ____-____mg/kg IV or ____-____mg/kg IM

A

1-2

4-5

39
Q

NDMR doses for PEDS are….

A

the same as adults

40
Q

Which do you use more in kids… oral or nasal airway?

A

oral

41
Q

Beyond 2 years of age the formula for uncuffed ETT sizes is —>

A

[age(yrs) + 16]/4

42
Q

At 1-2 yrs old, the uncuffed ETT size should be between ___-___

A

4-5

43
Q

A premature baby less than 1000gms should have an ETT size of__________

A

2.5

44
Q

A premature baby greater than 1000gms should have an ETT size of ______

A

3

45
Q

A neonate to 1 year old should have an uncuffed ETT size of _____-_____

A

3-4

46
Q

Your cuff leak should be between ___-___cm

A

20-30

47
Q

To estimate the size of a cuffed ETT in PEDS what should you do?

A

use the uncuffed formula and then subtract 1/2 size

48
Q

Cuff pressure should be

A

25

49
Q

You would use a miller 2 or Mac 2 in children aged > _______

A

6

50
Q

you would use a miller 0 in ______

A

neonates to 2yo

51
Q

A miller 1 is best used in ages ____-____

A

2-6

52
Q

The formula for ETT insertion distance is:________________ this comes into effect after age _____

A

age/2 +12

2

53
Q 
The estimated circulating volumes are:
Preemie:\_\_\_\_\_\_ ml/kg
Neonate:\_\_\_\_\_\_
Infant:\_\_\_\_\_\_
Child >6: \_\_\_\_\_\_
A

90-100
80-90
75-80
65-75 ml/kg

54
Q

The neonate has a HCT of ____%…. which is primarily HBG-____

A

55

F

55
Q

To estimate the volume of PRBCs you should transfuse… the equation is:

A

EBV x Desired HCT x (actual HCT/HCT of PRBCs)

56
Q

The platelet dose in PEDS is ____-____U/kg

A

.1 - .3

57
Q

The best fluid to give pecs for deficits and third space losses is __________ and the best for maintenance is ___________

A

LR

D5 .45NS

58
Q

With NPO guidelines the child may have clear liquids ____ hours prior to induction

A

2

59
Q

A baby can have breast milk until ____ hours preop

A

4

60
Q

Less than ____ months, the baby probably does not need a premed

A

9

61
Q

By ____ months to _______ age, the peds patient will probably need a premed such as versed

A

10 - preschool

62
Q

The dose for ketamine premed IM is ___-___mg/kg

A

5-10

63
Q

Premedication doses in PEDS for midazolam are ____mg/kg PO, ____ mg/kg nasal, and ___mg/kg IM

A

.4 (roughly)
.2
.1

64
Q

Treatment for laryngospasm in order:
1.
2.
3.

A

Jaw Lift
Positive pressure ventilation
Sch .5-1.0mg/kg IV

65
Q

Post Intubation croup is treated with _____________ &/or _____________

A

dexamethasone (.25-.5 mg.kg)

Racemic Epinephrine

66
Q

For a caudal epidural block you use a ___-___mm short beveled needle into the _____________

A

2-3mm

sacral canal

67
Q

There is a high failure rate for caudal epidural blocks in patients older than ______ years

A

7

68
Q

Dosing for caudal epidural blocks go from _____cc/kg for sacral to ______ cc/kg for mid thoracic block with a max of _____ cc’s.

A

.5
1.25
20

69
Q

Blood volume approximations: _____ml/kg for a premature infant

A

100

70
Q

Blood volume approximations: _____ml/kg for a full term infant

A

90

71
Q

Blood volume approximations: _____ml/kg for a baby 3 to 12 months old

A

70-80

72
Q

Blood volume approximations: _____ml/kg for a child > than 1 yo

A

70

73
Q

HgbF is ___-____% of the hgb at burt. This will change to adult hgb by ___ months

A

70-80%

6

74
Q 
The Average hgb concentrations are: 
Premature infant: \_\_\_-\_\_\_ g/dL
Full Term Infant \_\_\_-\_\_\_
2-6 months old \_\_\_-\_\_\_
6months to 6 years old  \_\_\_-\_\_\_
6yo -12yo  \_\_\_\_-\_\_\_\_
A 
13-15
18-20
9-13
12-13
13-14
75
Q

The P50 for hgbF is _____ compared to _____ for adults

A

18-20

26.6 (27)

76
Q

CMRO2 and CBF levels are _______ in children and _______% lower in neonates compared to adults

A

double

20

77
Q

Autoregulation to the brain in PEDS is about ____-____mmHg for MAP vs ___-____mmHg in adults

A

20-80

60-160

78
Q

The anterior fontanelle closes by ____months and the posterior is ____ months

A

20

3

79
Q

The total body water % in a term newborn is around _____% versus ____% in an adult

A

78

55

80
Q

An infant will have a a smaller or larger Vd of water soluble drugs?

A

larger

81
Q

Infants carry their water more intracellularly or extracellularly?

A

extracellularly - at risk for dehydration

82
Q

____________ is a congenital facial anomaly that presents as micrognathia, glossoptosis, and cleft palate. It gets better or worse with age?

A

Pierre Robin Syndrome

Better

83
Q

Treacher- Collina syndrome gets better or worse with age?

A

worse

84
Q

In children ____ml/kg of PRBC will increase the HCT by 1%

A

4

85
Q

The HCT of PRBC is _____%

A

60

86
Q

Give FFP if you give a massive blood transfusion of > ___-___ the childs blood volume

A

1-1.5

87
Q

Transfusion rates > ____ml/kg/min of FFP can lead to severe hypocalemia

A

1

88
Q

The starting dose of platelets is between ___- ___ U/kg

A

.1 - .3

89
Q

The IV induction dose of Propofol for

A

3

2.2

90
Q

The IV induction dose of ketamine is __-__mg/kg. The IM dose is __-__mg/kg and the PO dose is ___-___mg/kg

A

1-2
3-4
5-6

91
Q

Precedex is a __________ agonist. Its PEDs dosing is ___-____mcg//kg IV BOLUS followed by ___-____mcg/kg/HR infusion

A

alpha-2 Adrenergic agonist
.7-1
.5-1

92
Q

Dosing for Fentanyl is ___-___mcg/kg increments for a total of __-___mcg/kg

A

.5-1

10-12

93
Q

Its okay to give Morphine after the age of _______ with an initial dose of ____mg/kg

A

> 6 months

.1

94
Q

DOsing for Remifentanyl is ___-___mcg/kg bolus followed by an infusion at ___mcg/kg/min

A

.1-.25

.25

Coexisting Diseases (4 decks)

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