Peds Basics Flashcards
1
Q
breathing bag size
- preemies
- newborn
- 40-50 kg
- adults/teens
A
- 250 mL
- 500 mL
- 1 liter
- 2 liters
2
Q
after how many missed breaths of ETCO2 should you be correcting something?
A
1
3
Q
use a buritol for all infants less than how many kg?
A
10 kg
4
Q
Rescue drugs (mg/kg):
- IV atropine
- IM atropine
- IV succs
- IM succs
A
- 0.01 mg/kg
- 0.02 mg/kg
- 2 mg/kg
- 4 mg/kg
5
Q
epi light:
- concentration (mcg/mL)
- code dose (mcg/kg)
A
- 10 mcg/mL
2. 10 mcg/kg
6
Q
neo (neosynephrine) light:
- concentration (mcg/mL)
- used for children with which type of cardiac shunt?
- mix 10 mg vial into how many mLs of 0.9 NS?
A
- 20 mcg/mL
- R-L
- 500 mL
7
Q
temp:
- what is central core temp?
- hypothermia is core temp less than what?
- what is celsius equation?
A
- 37 +/- 0.2 C
- 36.1 C
- C= 0.56 (F-32)
8
Q
hypothermia (ranges):
- mild
- moderate
- severe
A
- 33.9-36.0
- 32.2-33.8
- below 32.2
9
Q
what type of temp technique is considered just as effective as pulm artery monitoring?
A
bladder
10
Q
what is the most unreliable method of monitoring temp?
A
skin
11
Q
what are 2 reasons why pre and full term neonates and infants lose heat fast?
A
- large skin surface area compared to total body mass
2. thin layer of subcutaneous fat
12
Q
evaporation heat loss in infants is greater because of a reduced amount of what content in the infant’s skin? (K)
A
keratin
13
Q
infant’s head:
- what % of total body surface area?
- is it the greatest source of heat loss?
A
- 20%
2. yes
14
Q
cold stress:
- increases or decreases metabolic rate which leads to an increase or decrease in O2 consumption?
- what develops d/t pulm vasoconstriction?
A
- increases, increases
2. acidosis
15
Q
neonates lose what % of heat by these methods:
- radiation
- convection
- evaporation
- conduction
A
- 39%
- 34%
- 24%
- 3%
16
Q
infant heat generation:
- primarily in what tissue?
- this tissue differentiates between what week range of gestation?
- what nerve fibers innervate this highly vascular tissue?
- what is released to increase metabolic activity in this tissue?
- CO is increased what %?
- nonshivering thermogenesis may continue until what age?
A
- brown adipose
- 26-30 weeks
- B-sympathetic
- NE
- 25%
- 2
17
Q
effects of hypothermia:
- vasoconstriction or dilation?
- increased or decreased risk of apnea?
- does central blood increase or decrease?
- arrythmias may result from what as a result of fatty acid breakdown? (A)
- does metabolic rate increase or decrease?
- hyper or hypoglycemia?
- increase or decrease wound infections?
- increase or decrease wound healing?
- increased or decreased bleeding?
- increased or decreased drug metabolism?
- what cardiac adverse effect can occur? (I)
- does a weak cry/lethargy occur?
A
- vasoconstriction
- increase
- increase
- acidosis
- increase
- hypoglycemia
- increased
- decreased
- increased
- decreased
- ischemia
- yes
18
Q
up to what % of children exhibit psychological and/or physiologic manifestations of anxiety in the preop period?
A
75%
19
Q
premeds:
- what is PO versed dose? (mg/kg)
- what is max PO mg of versed d/t volume?
- what is IM dose of versed? (mg/kg)
A
- 0.5 mg/kg
- 20 mg
- 0.1 mg/kg
20
Q
ketamine dart doses:
- ketamine (mg/kg, range)
- atropine (mg/kg)
- midazolam (mg/kg)
A
- 2-5 mg/kg
- 0.01 mg/kg
- 0.1 mg/kg
21
Q
what 4 syndromes are associated with being a difficult airway? (DS, TC, PR, M)
A
- down syndrome
- treacher collins
- pierre robin
- mucopolysacrodosis
22
Q
what syndrome is commonly associated with micrognathia?
A
pierre robin
23
Q
what the triad of symptoms of pierre robin syndrome? (M, CP, G)
A
- micrognathia
- cleft palate
- glossoptosis (downward displaced tongue)
24
Q
inhalation induction: add sevo with nitrous once sedation from nitrous has begun, or if the child fails to tolerate what? (M)
A
masking
25
why doesn't the mask leave the child's face during inhalation induction?
because it decreases the amount of time in stage 2
26
after loss of consciousness what is added to stent open soft tissues?
5 cmH2O of PEEP
27
should you consider the amount anesthesia before inserting an OA?
yes
28
why should you consider the amount of anesthesia before inserting an OA?
if too light can cause laryngospasm
29
the earlier IV placement the better, however placement during stage 2 can cause the patient to do what 2 things? (M, L)
1. move
| 2. laryngospasm
30
should the patient always be breathing spontaneously before IV placement?
yes
31
deepening the pt too much before IV placement can cause them to do what 2 things? (H, B)
1. hypotensive
| 2. bradycardic
32
up to what % of children experience emergence delirium?
80%
33
larynx is more cephalad or caudal and more anterior or posterior?
cephalad, anterior
34
what shape is the epiglottis? (O)
omega
35
what is the range of O2 consumption mg/kg/min?
6-8 mg/kg/min
36
where should blanket be for sniffing position for these age groups?
1. infant
2. children
3. adults
1. shoulder
2. none
3. head
37
what does adding an OA do to your mask size requirements?
increases it
38
which supraglottic airway is designed to facilitate intubation?
Air-Q
39
Air-Q sizing: what kg range goes with these sizes?
1. 1
2. 1.5
3. 2
4. 2.5
5. 3.5
1. 4-7 kg
2. 7-17 kg
3. 17-30 kg
4. 30-50 kg
5. 50-70 kg
40
LMA unique sizing:
1. 1
2. 1.5
3. 2
4. 2.5
5. 3
6. 4
7. 5
1. <5 kg
2. 5-10 kg
3. 10-20 kg
4. 20-30 kg
5. 30-50 kg
6. 50-70 kg
7. 70-100 kg
41
what is the narrowest cartilage of the infant's larynx?
cricoid cartilage
42
infants are considered obligate what breathers? (N)
nasal
43
progressive tone with deepening anesthesia results in progressive airway obstruction at the level of what 2 structures? (SP, E)
1. soft palate
| 2. epiglottis
44
as the depth of propofol anesthesia increases, the most pronounced narrowing is in the hypopharynx at the level of the what? (E)
epiglottis
45
what is the most effective way to improve airway patency and ventilation in children during adenotonsillectomy: chin lift, jaw thrust, CPAP?
jaw thrust
46
Blades:
1. MIller good for what age group with what type of airway?
2. Mac good for what range age groups?
3. Wis-Hipple is good for what age range?
4. Wis-Hipple is good for what kg range?
1. infants
2. toddlers to adults
3. 3-5
4. 15-25 kg
47
ETT size:
1. preemies less than 1.5 kg
2. preemies 1.5-2.5 kg
3. neonates
4. infants under 6 months old
5. infants 6 months to 1 year (range)
1. uncuffed 2.5
2. uncuffed 3
3. cuffed 3.0
4. cuffed 3.0
5. cuffed 3.5-4.0
48
what is the uncuffed equation for toddlers to teens?
age/4 + 4
49
a cuffed ETT is decreased how much in size?
0.5
50
ETT diameter should be around the diameter of what finger?
pinkie
51
what is the approximate internal diameter size (mm) for these ages?
1. 0-4 months
2. 4-12 months (range)
3. 10 months-2 years
4. 2-3 years
5. 3-5 years
6. 6-10 years
7. 10-14 years
8. 15-18 years (range)
1. 3.0
2. 3.5-4.0
3. 4.0
4. 4.5
5. 5.0
6. 5.5
7. 6.0
8. 6.5-7.0
52
general rule, ETT starting point placement at the lip should be how many times the size of the ETT?
3 times (3.0 should be 9 cm at the lip)
53
there should be an airleak at what pressure ranges?
20-25 cm H2O
54
are MAC values higher or lower in a child?
higher
55
children less than how many years almost never have PONV unless they are having a highly emetogenic procedure?
2 years
56
what 3 procedures are highly emetogenic? (T&A, EM, M/TS)
1. tonsillectomy and adenoidectomy
2. eye muscle
3. mastoid/tympanic surgery
57
what group of peds have high rates of nausea?
teenage girls
58
PONV treatment:
1. what is zofran dose? (mg/kg)
2. what is decadron dose? (mg/kg)
3. up to how many mg of decadron prior to surgical stimulation?
4. how many mL/kg of IVFs?
1. 0.1 mg/kg
2. 0.1 mg/kg
3. 10 mg
4. 20 mL/kg
59
emergence delirium:
1. most frequently occurs after a short or long anesthetic with VAs in what age group?
2. what 1 type of drugs and 2 drugs are used for treatment? (N, P, P)
1. short, toddlers/preschool age
| 2. narcotics; propofol, precedex
60
what is propofol dose for emergence delirium? (mg/kg)
1 mg/kg
61
TV (mL) for these age groups:
1. newborn
2. 1 year
3. 3 years
4. 5 years
5. 12 years
6. adult
1. 20 mL
2. 80 mL
3. 110 mL
4. 270 mL
5. 480 mL
6. 575 mL
62
arterial pH range for these age groups:
1. newborn
2. 1 year to adult
1. 7.3-7.4
| 2. 7.35-7.45
63
PaO2 range for these age groups:
1. newborn
2. 1 year to adult
1. 60-90 mmHg
| 2. 80-100 mmHg
64
PaCO2 range for these age groups:
1. newborn
2. 1 year to 12 years
3. adult
1. 30-35 mmHg
2. 30-40 mmHg
3. 37-42 mmHg
65
RR with +/- for these age groups:
1. newborn
2. 1 year
3. 3 years
4. 5 years
5. 12 years
6. adult
1. 50 +/- 1
2. 24 +/- 6
3. 24 +/- 6
4. 23 +/- 5
5. 18 +/- 5
6. 12 +/- 3
66
what % of peds cases are outside of the OR?
30%
67
is it worth showing the MRI suite to children?
no
68
where should children with difficult airways be anesthetized before transportation to MRI?
OR
69
SPECT scan should occur what range of hours after a seizure?
1-6 hours
70
PET scan:
1. child gets dextrose solution how many minutes before the scan?
2. if scan is for seizure activity, it much be done within how many hours of the seizure?
3. pt is at risk of what because of dextrose containing solution? (H)
1. 20 minutes
2. 1 hour
3. hypovolemia
71
anaphylaxis shock:
1. what is epi dose? (mcg/kg)
2. what is epi gtt rate range? (mcg/kg/min)
3. what is hydrocortisone dose? (mg/kg)
1. 10 mcg/kg
2. 0.05-0.2 mcg/kg/min
3. 10 mg/kg
72
minor reaction skin:
| what is benadryl dose? (mg/kg)
1 mg/kg
