Random stuff

Question 1

Favorable Wilms stage 1-2

Answer 1

Dactinomycin vincristine

Question 2

Favorable Wilms 3-4

Answer 2

Dactinomycin vincristine doxorubicin
XRT depending on location

Question 3

Wilms w/ focal anaplasia

Answer 3

1. Dactinomycin vincristine
   2-4. Dactinomycin vincristine doxorubicin XRT

Question 4

Wilms w/ diffuse anaplasia

Answer 4

Vincristine doxorubicin cyclophosphamide etoposide XRT

Question 5

Neuroblastoma high risk

Answer 5

5 drug Cyclophosphamide, Cisplatin, doxorubicin, vincristine, etopiside
High risk consider XRT.
Retinoic acid.
Anti-GD2

Question 6

Hepatoblastima
Low
Intermediate
High

Answer 6

Well differentiated/fetal or embryonal - cisplatin, 5-fluorouracil and vincristine (C5V)
Unresectable or small cell undifferentiated - cisplatin, 5-fluorouracil and vincristine with doxorubicin (C5VD)
Metastatic or AFP <100vincristine/irinotecan/temsirolimus (VIT) with C5VD

Question 7

Germ cell tumors

Answer 7

PEB

Question 8

Rhabdomyosarcoma chemo
Low
Intermediate
High

Answer 8

VAC
VAC (high dose cyclophosphamide)
VAC + irinotecan, etoposide, doxorubicin
XRT for all but group 1 embryonal & fusion negative

Question 9

Ewing’s chemo

Answer 9

5 drugs. Vincristine cyclophosphamide doxorubicin etopiside ifosphamide
XRT for positive margins

Question 10

TPN - total volume

Answer 10

Start at 80 mL/kg/day
Up to 140-160 mL/kg/day over first week of life. Even 180 for gastroschisis

Question 11

TPN - total calories

Answer 11

100/kg/day
120 in preemies
75-90 in 1-7 year olds
25 in adults

Question 12

TPN - protein

Answer 12

2-3 g/kg/day
1 in adults. 15% total calories

Question 13

TPN - carbs

Answer 13

6-12 g/kg/day
45% total calories

Question 14

TPN - lipids

Answer 14

1 g/kg/day
Can increase to max of 3
40% total calories

Question 15

Haller index

Answer 15

Max transverse diameter/min AP (sternum to vertebral body)
3.25 to get fixed

Question 16

DSD labs

Answer 16

CBC, CMP
17-OH-progesterone high (salt wasting)
11 deoxycortisol high
ACTH
Cortisol
Older…
DHEA
FSH
LH
Testosterone
DHT for 5-alpha reductase deficiency

Question 17

Most common enzyme defect in CAH
Next most common

Answer 17

21 alpha hydroxylase
-Salt wasting, low Na, high K
11 beta hydroxylase
-Salt high, k low

Question 18

HFOV MAP

Answer 18

2-4 above conventional vent
10 babies
15 premies

Question 19

HFOV Power

Answer 19

About 1 more than weight in kg up to 6kg

Question 20

HFOV Hz

Answer 20

8-10 term
12-15 preterm

Question 21

HFOV increase oxygenation

Answer 21

MAP, FiO2

Question 22

HFOV increase ventilation

Answer 22

increase amplitude or power. Decrease frequency

Question 23

Conventional vent settings

Answer 23

IMV
Rate 60
FiO2 .6
PIP 20-25
PEEP 5
Volume 3-5 cc/kg