Peds week one

Question 1

Midazolam po :

Answer 1

0.5-0.7 mg/kg (max. 20 mg)

Question 2

Cefazolin IV :

Answer 2

25 mg/kg

Question 3

Succinylcholine IV :

Answer 3

1.5‐2 mg/kg

Question 4

Atropine IV :

Answer 4

10‐20 mcg/kg IV or 20‐40 mcg/kg IM, (no less than 0.1 mg)

Question 5

Propofol IV:

Answer 5

2‐4 mg/kg

Question 6

Vecuronium IV :

Answer 6

0.1 mg/kg

Question 7

Fentanyl IV :

Answer 7

1‐2 mcg/kg

Question 8

Hydromorphone IV :

Answer 8

10‐20 mcg/kg (10x the fentanyl dose)

Question 9

Neostigmine IV:

Answer 9

0.07 mg/kg (max 5 mg)

Question 10

Glycopyrrolate IV :

Answer 10

10 mcg/kg (no less than 100 mcg’s)

Question 11

Ondansetron IV :

Answer 11

0.1 mg/kg

Question 12

Versed iv:

Answer 12

0.05 mg/kg (1/10th of the PO dose)

Question 13

2 % Lidocaine iv:

Answer 13

1 mg/kg

Question 14

Dexamethasone iv (antiemetic):

Answer 14

0.1 mg/kg

Question 15

Prematurity

Answer 15

weighing less than 2500gm at birth.

Question 16

Preterm infant is born before

Answer 16

37 weeks

Question 17

Term infant is born after

Answer 17

37 wks and before 42

completed weeks of gestation.

Question 18

Post‐term infant is born after

Answer 18

42 completed

weeks of gestation.

Question 19

The preterm infant is less able to:

Answer 19

suck, shiver (maintain normothermia), swallow, eat, breathe

Question 20

Neonates are less than

Answer 20

30 days of age

Question 21

Infants are

Answer 21

1‐12 months of age

Question 22

Children are

Answer 22

1‐12 years of age

Question 23

Adolescents are

Answer 23

13‐19 years of age

Question 24

LBW = low birth weight

Answer 24

less than 2.5kg

Question 25

VLBW = very low birth weight

Answer 25

less than 1.5kg

Question 26

Extremely low birth weight is less than

Answer 26

1 kg.

Question 27

“Micropremies” = weighing less than

Answer 27

750gm

Question 28

At full‐term birth, the infant has a __ neck

Answer 28

short

Question 29

infants are prone to upper airway

obstruction during sleep.

Answer 29

they oughta come with their own little CPAP machines

Question 30

In infants with tracheostomy, the orifice is often
buried under the chin unless the head is extended
with a roll under the neck.

Answer 30

put a roll under the neck

Question 31

infants are more prone to upper airway
obstruction under GETA because upper airway muscles, which normally support the airway patency,
are disproportionally sensitive to the depressant
effect of GETA, resulting in pharyngeal airway
collapse and obstruction.
Coté

Answer 31

put in an oral airway

Question 32

infant’s larynx is more __ (C2‐3) vs. adult’s (C4‐5)

Answer 32

cephalad

Question 33

_ primary teeth

Answer 33

20

Question 34

__ permanent teeth

Answer 34

32

Question 35

AVOID nasal trumpets in children with

Answer 35

coagulopathy, thrombocytopenia, or suspicion of a

traumatic basilar skull fracture!!!

Question 36

What size LMA for child weighing <5 kgs

Answer 36

1

Question 37

What size LMA for child weighing 5-10 kgs

Answer 37

1.5

Question 38

What size LMA for child weighing 10-20

Answer 38

2

Question 39

What size LMA for child weighing 20-30 kgs

Answer 39

2.5

Question 40

What size LMA for child weighing 30-50

Answer 40

3

Question 41

What size LMA for child weighing 50-70 kgs

Answer 41

4

Question 42

How deep should you place the tube?

Answer 42

6 cm for a preterm 2000g, 10 cm for a newborn, 11cm for a 1‐y/o and 12cm for a 2y/o.

Question 43

(MRI/CT studies show __ as narrowest part of the infant larynx

Answer 43

subglottic

area

Question 44

Laryngospasm is ellicited by stimulation of ___

Answer 44

afferent fibers contained in

the internal branch of superior laryngeal nerve (SLN). Think A-I-SLN

Question 45

Laryngospasm treatment

Answer 45

identify and remove the offending
stimulus, apply jaw thrust (pressure on “laryngospasm notch” ‐ behind the earlobe), insert oral or nasal airway, apply positive pressure ventilation with 100%
O2, …., deepen anesthesia with SEVO or 0.5 mg/kg
propofol IV, …., 0.1mg/kg succinylcholine IV or up to 4
mg/kg IM (with Atropine 10‐20 mcg/kg IV or 20‐40 mcg/kg
IM)

Question 46

Which cells produce surfactant?

Answer 46

Type 2 pneumocytes

Question 47

At what gestational age is surfactant developed?

Answer 47

between 23-24 weeks gestation and increases in concentration during the subsequent 10 weeks of gestation

Question 48

What does the foramen ovale connect?

Answer 48

right atrium to left atrium, similar to a “valley” between the atria

Question 49

What does the ductus arteriosis connect?

Answer 49

Pulmonary arteries to aorta, so blood can skip pulmonary circulation.

Question 50

What are the two crucial events involved in the immediate transition from the fetal circulation to the normal postnatal pattern?

Answer 50

Decreased PVR and increased SVR (loss of the

umbilical circulation)

Question 51

The increase in systemic afterload causes an

Answer 51

immediate closure of the flap valve mechanism of
the foramen ovale and reverses the direction of
shunt through the ductus arteriosus

Question 52

Increased pulmonary vascular resistance in response

to hypoxia and acidosis may precipitate a reversal to

Answer 52

right‐to‐left shunting leading to cyanosis

Question 53

Because the Infant’s rib cage is cartilaginous and the thorax is too compliant to resist inward recoil of the lungs, the chest wall is easily deformed, tending to move
inward on inspiration.
Therefore, inspiration occurs almost entirely as a result of

Answer 53

diaphragmatic descent.

Question 54

Periodic breathing commonly occurs in newborns ‐recurrent

pauses in ventilation lasting no more than

Answer 54

5 to 10 seconds

Question 55

During hypoxemia, the principle response in adults is
systemic vasodilation, however,
 Neonates exposed to hypoxemia experience

Answer 55

pulm &
systemic vasoconstriction, bradycardia and
decreased cardiac output (CO). Give Atropine & 100% oxygen

Question 56

What is an appropriate SaO2 and PaO2 for premature infants?

Answer 56

SaO2 90-95%

PaO2 60-80 mmHg

Question 57

PCA = sum of

Answer 57

gestational age and chronologic age

Question 58

It is recommended that former preterm infants who
are 55 to 60 weeks’ PCA who are not anemic and
not experiencing apnea be observed for an extended
period of time and, if stable, later discharged.

Answer 58

However, infants younger than 55 weeks’ PCA, those

who are anemic (hematocrit

Question 59

Surgery is safe from the __ to the __ day postgestation in the full-term infant

Answer 59

15-56 day, or 2- 8 weeks

Question 60

elective or outpatient procedures should be deferred until the preterm infant reaches at least __ weeks post-conception

Answer 60

60 weeks post-conception

Question 61

Ductus venosus

Answer 61

(connection between the umbilical
vein and IVC) ‐ most umbilical venous blood from the
placenta bypasses the liver  IVC RA

Question 62

During the early neonatal period, reversion to the fetal circulation can occur: If hypoxia occurs, ___increases and reopens ductus arteriosus  decline
in arterial oxygenation which results in acidosis
which further increases ___ hypoxemia

Answer 62

PVR

PVR

Question 63

infants have a predominately ___ nervous system with a slowly improving

Answer 63

predominately parasympathetic, slowly improving sympathetic nervous system

Question 64

Stroke volume is __

Answer 64

fixed

Question 65

What is an appropriate heart rate for the infant?

Answer 65

100-180

Question 66

What is the estimated blood volume of the Preterm neonate

Answer 66

90‐100 ml/kg

Question 67

What is the estimated blood volume of the Full‐term neonate

Answer 67

80‐90

Question 68

What is the estimated blood volume of the Infant (< 12mo)

Answer 68

70‐80

Question 69

What is the estimated blood volume of the School‐age child (< 12 yrs)

Answer 69

70

Question 70

What is the estimated blood volume of the Teenager (> 12yrs)/ Adult

Answer 70

65‐70

Question 71

What is the estimated blood volume of the Obese child

Answer 71

60‐65