peds deck 10

Question 1

which murmurs are ALWAYS pathologic

Answer 1

murmurs accompanied by palpable thrill

Question 2

dose of epinephrine

Answer 2

0.02-0.1 mcg/kg/min

Question 3

anesthesia considerations for the pt with cardiac hx/dz

Answer 3

1. preop - need cardiac records 2. has family been compliant with meds and visits? 3. do you need cardiac consult before you proceed? 4. know what situations to give fluids and which to restrict 5. bubble precautions for “hole in the heart” 6. keep pt warm 7. decrease stress

Question 4

IV dose of acetaminophen

Answer 4

15 mg/kg

Question 5

nenate MAC of isoflurane

Answer 5

1.6

Question 6

Neonate MAC of sevoflurane

Answer 6

3.2

Question 7

Neonate MAC of desflurane

Answer 7

9.2

Question 8

induction dose of etomidate

Answer 8

0.2 mg/kg IV

Question 9

pediatric dose of succinylcholine

Answer 9

1.5-2 mg/kg

Question 10

pediatric dose of cisatracurium

Answer 10

0.2 mg/kg

Question 11

pediatric dose of atracurium

Answer 11

0.5 mg/kg

Question 12

pediatric dose of rocuronium

Answer 12

0.6-1.2 mg/kg (larger dose for RSI)

Question 13

pediatric dose of pancuronium

Answer 13

0.1 mg/kg

Question 14

pediatric dose of vecuronium

Answer 14

0.1 mg/kg

Question 15

pediatric dose of glycopyrolate (robinol)

Answer 15

0.015 mg/kg IV

Question 16

pediatric dose of atropine (for reversal)

Answer 16

0.03 mg/kg

Question 17

pediatric dose of neostigmine

Answer 17

0.06 mg/kg

Question 18

pediatric fentanyl dose

Answer 18

1-3 mcg/kg

Question 19

pediatric hydromorphone dose

Answer 19

0.01-0.02 mg/kg IV

Question 20

pediatric remifentanil dose (gtt)

Answer 20

0.1-1 mcg/kg/min

Question 21

pediatric dose of sufentanil gtt

Answer 21

0.1-0.5 mcg/kg/hr

Question 22

dose of zofran in peds

Answer 22

0.15-0.2 mg/kg

Question 23

dose of decadron pediatrics

Answer 23

0.5 mg/kg IV - max = 12

Question 24

dose of benedryl in peds

Answer 24

0.25 mg/kg IV

Question 25

what is a benefit to using fentanyl in peds?

Answer 25

cardiac stability

Question 26

_____________ is 10x more potent than fentanyl

Answer 26

sufentantil

Question 27

IV push dose of sufentanil in peds

Answer 27

0.05-0.2 mcg/kg

Question 28

IVP dose of remifentanil

Answer 28

0.5 mcg/kg

Question 29

what is a concern with remifentanil if you give a bolus

Answer 29

bradycardia and hypotension

Question 30

when would be good situations to use remifentanil intraop

Answer 30

1. TIVA 2. neurosurgical cases (due to short acting, wake up and move ext quickly)

Question 31

if you are adding clonidine to your regional block, what dose would you use?

Answer 31

1-2 mcg/kg

Question 32

benefits to using dexmedetomidine intraop

Answer 32

1. analgesic 2. neuroprotective properties 3. emergence delirium decreased 4. gives good sedation without DD resp dep 5. greatly reduces the need/amount of other anesthetics 6. prolongs regional blocks

Question 33

good cases to consider using precedex intraop

Answer 33

1.TIVA/neuromonitoring 2. spontaneous breathing 3. teenagers 4. pts with autism/behavioral disorders 5. anxiety

Question 34

In neuromonitoring cases, if dexmedetomidine gtt is run > ____________ mcg/kg/hr it can impair readings

Answer 34

0.5

Question 35

disadvantages to dexamethasone

Answer 35

1. can increase blood glucose 2. can decrease wound healing

Question 36

benefits of nitrous oxide

Answer 36

1. highly insoluble –> fast uptake and elimination 2.great for inhalational inductions 3. decreases MAC and need of volatile

Question 37

disadvantages to Nitrous oxide

Answer 37

1. increases PONV 2. expands closed spaces 3. can increase homocysteine levels

Question 38

respiratory risk factors from the preop hx that increase risk of perioperative event:

Answer 38

1. URI within previous 2 weeks 2. wheezing during exercise 3. more than 3 wheezing episodes in the past 12 months 4. nocturnal dry cough 5. eczema 6. smoking/vaping/passive smoke exposure 7. family hx of asthma, rhinitis, eczema

Question 39

the _____________ the patient the more likely they are to have perioperative pulmonary complications

Answer 39

younger

Question 40

RSV, flu, adenovirus, and pneumonia are all examples of ______________ airway infections

Answer 40

lower

Question 41

lower airway infections result in brochiolitis which results in…

Answer 41

1. swelling 2. hypoxia 3. hypercapnea 4. increased work of breathing leading respiratory failure

Question 42

_______________ is a disruption of electrolyte transport in sweat ducts, airway, and pancreas. This disruption leads to increase in sweat chloride concentrations –> viscous mucus production

Answer 42

cysfic fibrosis

Question 43

common surgeries neonates with Cystic Fibrosis present for

Answer 43

1. meconium ileus 2. meconium peritonitis 3. intestinal atresia

Question 44

common surgeries that children/teens present for with Cystic fibrosis

Answer 44

1. nasal polypectomy 2. IV access 3. ENT surgery

Question 45

common surgeries adults with Cystic Fibrosis present for

Answer 45

1. esophageal varicies 2. recurrent pneumothorax 3. cholecystecomy 4. lung transplant (w/ or w/o liver)

Question 46

tx of wheezing intraoperatively

Answer 46

1. deepen anesthetic 2. albuterol MDI or nebulizer

Question 47

what is the triad of sx that children commonly present with if they have hereditary spherocytosis

Answer 47

1. anemia 2. splenomegaly 3. jaundice

Question 48

T/F: most children with hereditary spherocytosis require chronic transfusions

Answer 48

false; only very small amount need chronic transfusion

Question 49

what are the most common operations performed in children with hereditary spherocytosis

Answer 49

1. splenectomy 2. cholecystectomy

Question 50

what is the purpose of the splenectomy in child with hereditary spherocytosis

Answer 50

1. RBC life span increases 2. which decreases the anemia and jaundice associated with the dz