Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Test 4 > Flashcards

Test 4 Flashcards

1
Q

Difference between apnea-hypopnea index of adults and peds

A

Peds require much less apnea episodes for diagnosis and increased severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 ways to actively cool the patient during acute MH episode

A

Lavage OG, bladder, open cavities

Administer cooled IV saline

Surface cooling

CPB in severe cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Elements of syndrome similar to MH

Cocaine intoxication

A

Fever

Rigidity

Rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type of craniosynostosis characterized by premature fusion of cranial sutures

A

Type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is tracheostomy often required for Pierre Robin Sequence

A

Glossoptosis (tongue further back in mouth)

Partial/complete obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of Goldenhar Syndrome

A

Vascular accident in the fetus

Blood supply cur off and clots in area of those tissues develop into the structures of the ear and lower jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is suspicion of MH greater in adults or children

A

Children

1: 10,000 peds
1: 50,000 adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Anesthetic agents absolutely contraindicated in patients with family history of MH

A

All volatiles

Succinylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Adapter from what size ETT will fit an IV catheter to attach to a breathing circuit

A

3.0 ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is prilocaine unsuitable for neonates

A

Metabolism to O-toulidine leading to methemoglobinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definition of MH

A

Life-threatening clinical syndrome of hyper metabolism involving skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long does it take for activated charcoal filter to reduce exposure to volatiles once applied to circuit

A

<90 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Type of cerebral palsy

Tense, contracted muscles

A

Spastic CP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Next treatment steps

A

Administer dantrolene sodium (Ryanodex)

Activated charcoal filters on circuit

TIVA

Hyperventilate

Aggressive IV hydration

Actively cool patient

Aline, central line, foley

Send labs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug of choice for MH

A

Ryanodex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA of cystic fibrosis

A

Mutant CFTR channel does not move chloride ions causing sticky mucus to build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 syndromes associated with Craniosynostosis

A

Apert

Pfieffer

Crouzon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Components of Elma cream

A

Prilocaine

Lidocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why is the half life of ester LAs prolonged in infants

A

Decreased plasma cholinesterase activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adults insulin and dextrose dose for hyperkalemia

A

Regular insulin 10 units

50 ml D50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Intubation with Down’s syndrome kid

A

Avoid excessive flexion, rotation, or neck extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Iced saline dosage for MH

A

10ml/kg every 10 minutes for 30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Development and intelligence in Treacher Collins

A

Normal development and intelligence

Need early hearing and speech interventions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which drugs should be avoided in patient with family hx of MH

A

Succinylcholine and volatiles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How fast may temperature increase during MH episode

A

1-2 degrees Celsius every 5 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sown slanting eyes

Lower jaw small and receding

Macrostomia

Microtia

Coloboma

A

Treacher Collins Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Type of craniosynostosis

Cloverleaf shape of skull

Hampers normal brain growth

Mental retardation

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

High incidence of MH in what areas of US

A

Wisconsin

Nebraska

West Virginia

Michigan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Most cases of cerebral palsy are related to what risk factor

A

Antenatal

  • prematurity and LBW
  • intrauterine infections
  • multiple gestation
  • pregnancy complications

70-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Induction of post tonsillectomy bleed patient

A

RSI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Cormack and Lehane laryngoscopic grading system

Visualization of just soft palate

A

Grade IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Neonates do not metabolize which LA

A

Mepivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

OSA MOA

A

Partial or complete collapse of upper airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Skull deformities (premature closure of cranial sutures)

Eyes abnormally far apart

Fusing or webbing of digits and other abnormalities

A

Craniosynostosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Unilateral or bilateral underdevelopment of mandible, microtia, reduction in size and flattening of maxilla

A

Goldenhar Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Max recommended dosage and duration

2-Chloroprocaine

A

Max 20 mg/kg

30-60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Elements of syndrome similar to MH

Serotonergic toxicity is associated with what

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Decrease in airflow lasting > 10 seconds with 30% 02 reduction in airflow and at least 4% desaturation from baseline

A

Hypoapnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Summation of number of obstructive apnea and hypopnea events

A

Apnea hypopnea index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Children scheduled for T&A have high incidence of

A

Airway reactivity

Laryngospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Primary triggers for MH

A

Succinylcholine

All volatile agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Down syndrome are at increased risk of

A

Post intubation stridor

Hypothyroidism

Atlanto-occipital instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Force diuresis with prevention of ARF with MH want UOP of what

A

2ml/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Narrowing of upper airway and indication of impending upper airway closure

A

Flow limitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Major advantage of electrocautery with adenotonsillectomy

A

Reduction in intraop blood loss

And post op primary and secondary hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Analgesia from Bupivacaine can last how long in peds

A

Up to 4 hours

Less in small infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Initial steps in treating MH

A

Call for help

DC triggering agent

Hyperventilate with 100% O2

Notify surgeon, anesthesia team, nursing

Ask for MH cart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Why might 2.5mg/kg dantrolene be administered to a patient preoperatively

A

To prevent, prophylactically an episode of MH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Single palmar crease

A

Simian crease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Max recommended dosage and duration

Procaine

A

Max 10 mg/kg

60-90 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Type of cerebral palsy

Poor sense of balance, often causing falls and stumbles

A

Ataxic CP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Uncontrolled and excessive release of Ca in skeletal muscles leads to

A

Overwhelms the bodies capacity to supply O2 (HYPOXIA)

Elevates CO2 (high ETCO2)

Excessive heat production (INCREASED TEMP)

Circulatory arrest and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

To prevent PONV in child with T&A with OSA

A

Suction stomach

Hydrate well

IV airway Decadron dose

Zofran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

3 major features result from Klippel-Feil Syndrome

A

Short neck

Limited ROM in neck

Low hairline at back of head

most have 1 or 2 of these

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Simian crease associated with what

A

Downs

Fetal alcohol syndrome

Aarskog syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Autosomal recessive disorder

Disruption of electrolyte transport in epithelial cells

A

Cystic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Small mouth

Hypoplastic mandible

Protruding tongue

Possible difficult intubation

Atlanto-occipital instability

A

Downs Syndrome. Trisomy 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Syndromes that share elements of MH

A

Hyperthyroidism

Sepsis

Pheochromocytoma

Metastatic carcinoid

Cocaine intoxication

Heat stroke

Masseter spasm

Neuroleptic malignant syndrome

Serotonergic toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Supportive therapy for MH

A

Correct acidosis and hyperkalemia

Send labs

Monitor for rhabdo, arrhythmia, ARF

Prepare for transport to ICU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Cormack and Lehane laryngoscopic grading system

Visualizaiton of posterior area of cords

A

Grade II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

3 concerns related to anesthetizing a downs patient

A

Possible difficult intubation (large tongue, short neck, small mouth, subglottic stenosis)

Atlanto-occipital dislocation

Congenital heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Conditions where normal tissue in or around the eye (iris, retina, choroid, optic disc) is missing from birth

A

Coloboma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

In event of PVC, dysrhythmia, or cardiac arrest with MH assume what

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Regional anesthesia and pulmonary function in kids having thoracic or upper abdominal procedures

A

Improves pulmonary function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Anesthesia considerations with cystic fibrosis

A

Anxiolytics

Hydrate

Nebulized saline pre and post op

Humidified circuit

High PIP expected

Suction ETT under deep GETA

AVOID GLYCOPYROLLATE

Reverse isolation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Late signs of MH

A

Truncal and/or masseter rigidity

Hyperkalemia

Arrhythmia

Myoglobinuria (coke colored urine)

Rhabdomyolysis (increased CPK)

Coagulopathy (DIC)

MOSF

Death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

You continue giving ryanodex at what dose how often

A

1mg/kg every 4-8 hours for 24-48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Which LA not metabolized in neonates

A

Mepivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Secondary post tonsillectomy bleeding occurs when

A

5-10 days after T&A

Eschar covering tonsillar bed retracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Correction of hyperkalemia

Peds

A

Regular insulin 0.1 unit/kg IV and D50 0.5gm/kg

CaCl 10 mg/kg

Ca gluconate 30mg/kg

Albuterol, kayexelate, dialysis, ECMO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Underdevelopment or absence of cheekbones and side wall and floor of eye socket

A

Macrostomia

72
Q

Primary post tonsillectomy bleeding occurs when

A

W/i first 24 hours

73
Q

Avoid what drugs with ryanodex. Why

A

Calcium channel blocking agents

Life threatening hyperkalemia may result

74
Q

Children with long standing OSA show what anatomic changes in heart?

Can be caused by what?

A

PA HTN and RVH

Can be caused by hypertrophied tonsils

75
Q

Cessation of airflow lasting <10seconds

A

Apnea

76
Q

Hepatic metabolism of prilocaine makes what

A

O-toulidine

77
Q

7 early signs of MH

A

Tachycardia

Hypertension

Tachycardia

Increased ETCO2

Increased O2 consumption

Increased temperature 1-2 degrees every 5 minutes

Metabolic and respiratory acidosis

78
Q

Who is susceptible to MH

A

Autosomal dominant trait

Ryanodine receptor 1 gene mutation

79
Q

Ester LA half life in infants

A

Prolonged

80
Q

If you dont have a 3.0 ETT adapter how to you ventilate with cricothyrotomy with needle

A

3ml syringe attatched to IV catheter

Insert 8.0 ETT into syringe barrel

Attach to breathing circuit

81
Q

Max recommended dosage and duration

Tetracaine

A

Max 1.5 mg/kg

3-10 hours

82
Q

Patients classified as +3 or greater are at increased risk of what

A

Developing airway obstruction during anesthetic induction

83
Q

Dose of LA for peds should be based on

A

Age

Physical status

Area to be anesthetized

Weight by lean body mass

84
Q

Type of cerebral palsy

Constant, uncontrolled motion of head, limbs, and eyes

A

Athetoid CP

85
Q

Major disadvantage of electrocautery with adenotonsillectomy

A

Greater pain

Poor PO intake post-op

86
Q

Amide LA metabolism

A

Degraded by cytochrome P450

87
Q

Patient with MH crisis has PVCs. What is antiarrythmic drug of choice

A

Procainamide 15mg/kg IV

Or lidocaine

88
Q

At what age is chest palate usually repaired

A

12-18 months of age

89
Q

T&A performed for what reason

A

Chronic or recurrent tonsillitis and obstructive adenotonsillar hyperplasia

90
Q

Term to describe group of chronic conditions affecting body movement and muscle coordination

A

Cerebral palsy

91
Q

Diagnostic test for MH

How is it done

Is it sensitive

A

Halothane caffeine contracture test

Skeletal muscle biopsy placed in halothane

Sustained contraction of muscle is diagnostic

Not very sensitive and many false positives

92
Q

Preparations f Ryanodex

A

Dilute with 5 ml sterile water

250 mg/vial

93
Q

11 clinical manifestations of MH

A 
Hypercarbia
Tachycardia
Tachypnea
Hyperthermia
Hypertension
Cardiac dysrhythmias
Acidosis (metabolic)
Hyperkalemia
Skeletal muscle rigidity
Myoglobinuria
Hypoxemia
94
Q

Earliest sign of rhabdo is

A

Myoglobinuria/myoglobinemia

95
Q

Type of craniosynostosis

Similar to type 2 but cloverleaf skull not present

A

Type 3

96
Q

Most common form of sleep-disordered breathing

A

Obstructive sleep apnea

97
Q

Chronic airway obstruction with tonsilar hyperplasia results in

A

OSA

CO2 retention

Cor pulmonale

Failure to thrive

Swallowing disorders

Speech abnormalities

98
Q

Type 1 craniosynostosis

Other abnormalities

Intelligence

Survival rate

A

Recessed cheekbones, finger and toe abnormalities

Normal intelligence

Significant survival rate

99
Q

Methods to correct acidosis

A

Hyperventilate

Sodium bicarb 8.4%. 1-2 mEq/kg

100
Q

Metabolisms of prilocaine

A

Hepatic metabolism of prilocaine can lead to methemoglobinemia

101
Q

Children of what gender and with what conditions are more susceptible to MH

A

69% male

Some form of muscular dystrophy or strabismus

102
Q

Tonsilar hyperplasia may lead to what

A

Chronic airway obstruction

103
Q

How to prevent ARF with MH

A

IV fluids

Force diuresis

Bicarb infusion if CPK or K rise

104
Q

How long do MH patients need to be observed in ICU

A

36 hours

105
Q

Reduced risks of cardiac and neurologic toxicities compared with bupivacaine

A

Ropivacaine

106
Q

Bone disorder characterized by abnormal fusion of 2 or more cervical vertebrae present from birth

A

Klippel-Feil Syndrome

107
Q

VACTERL (VATER) syndrome

A

Vertebral anomalies

Anal or intestinal atresia

Cardiac anomalies

TEF

Renal malformations

Limb defects

108
Q

Post tonsillectomy bleeding is a

A

Surgical emergency

109
Q

Max recommended dosage and duration

Ropivacaine

A

2 mg/kg

2-4 hours

110
Q

Children with severe OSA produce what response to opioids

A

Exaggerated respiratory depression to smaller doses of opioids

111
Q

OSA pt having T&A discharge criteria

A

With OSA stay overnight with pulse ox and apnea monitor

Non OSA stay 6-8 hours for observation

112
Q

Woman in labor is ID as behind susceptible to MH. What anesthetic techniques are acceptable

A

Epidural without dantrolene pretreatment for routine labor

If GETA give dantrolene prophylactically and use non triggering agents

113
Q

Elements of syndrome similar to MH

Pheochromocytoma

A

Difference is marked BP swings

114
Q

Type of cerebral palsy

Uncontrollable shaking, interfering with coordination

A

Tremors CP

115
Q

A patient has just experienced masseter muscle rigidity from succinylcholine. What lab may confirm the diagnosis

A

Elevated CPK

> 20,000

116
Q

regional anesthesia considerations in jaundiced neonate

A

Bilirubin may further reduce potential for protein binding

Extends half life of LA

117
Q

Syndromes predicting difficult intubation

A

Pierre Robin Sequence

Treacher Collins

Goldenhar

Beckwith-Wiedemann

Kippel Fiel

Apert, Pfieffer, Crouzon

118
Q

When using bipolar electrocautery during adenotonsillectomy

A

Keep Fi02 low

High risk of airway fire

119
Q

Is halothane caffeine contracture test a good diagnostic test for MH

Why

A

No because too many false positives

120
Q

MH episode may not occur with every exposure to trigger agent. Clinical manifestations may depend on (3)

A

Genetic predisposition

Dose of trigger agents

Duration of exposure

121
Q

Which more serious primary or secondary post tonsillectomy bleed

A

Primary more serious

More brisk and more profuse

122
Q

Earliest sign of MH

A

Increased ETCO2

123
Q

Doses of amides should be decreased by how much in infants < 6 months old

A

Decrease by 30%

124
Q

Cormack and Lehane laryngoscopic grading system

Visualization of just epiglottis

A

Grade III

125
Q

VATER Syndrome growth and development

A

Small stature

Normal development

Normal intelligence

126
Q

What size IV catheter for percutaneous cricothyrotomy

A

12-14 G

127
Q

Once the initial episode of MH is controlled the patient remains at risk for what 5 complications

A

Reoccurrence

DIC

Myoglobinuric renal failure

Skeletal muscle weakness

Electrolyte abnormalities

128
Q

Extubation of T&A

A

Fully awake

Suction stomach and pharynx

Have nasal airway in place

129
Q

Cause of cerebral palsy

A

Damage to one or more specific areas of brain

Usually during fetal development

130
Q

Macroglossia

Visceromegaly

Omphacele

A

Beckwith-Wiedemann Syndrome

131
Q

Myringotomy and ventilating tube insertion anesthetic plan

A

GETA

Sevo inhalation induction

No IV

Mask ventilation

Intranasal fentanyl

132
Q

Children with cardiac valvular disease and tonsilar hyperplasia

A

Risk for endocarditis due to recurrent strep bacteremia secondary to infected tonsils

133
Q

Ester LA metabolism

A

Hydrolyzed by plasma cholinesterases

134
Q

During preop you discover positive family history for MH. What 6 steps should be taken

A
  • standard premeds. Low normal HR
  • remove vaporizers, change absorbent, Flush 02 at 10l/min for >10 minutes
  • measure ETCO2
  • core body temp measurement
  • Aline and central line
  • observe closely in postop period
135
Q

Rapid breakdown of muscle tissue

A

Rhabdomyolysis

136
Q

Child undergoing surgery with halothane develops tachycardia, increased temperature, and skeletal muscle rigidity. What is drug of choice?

A

Dantrolene 2.5 mg/kg

137
Q

What syndrome can mimic MH

A

Neuroleptic malignant syndrome

But develops over 24-72 hours

138
Q

Type of cerebral palsy

Tight muscles that resist effort to make them move

A

Rigidity CP

139
Q

Elements of syndrome similar to MH

Metastatic carcinoid

A

Flushing

Diarrhea

Hypotension

140
Q

MH

Uncontrolled and excessive Ca release in skeletal muscles can lead to

A

Sustained muscle contraction

Drastic and uncontrolled increase in oxidative metabolism in skeletal muscle

141
Q

At what body temperature should cooling of MH patient be stopped? Why?

A

38 degrees Celsius

To prevent deleterious effects of hypothermia

142
Q

Max recommended dosage and duration

Mepivacaine

A

7mg/kg

2-4 hours

143
Q

Max recommended dosage and duration

Bupivacaine

A

Max 2.5 mg/kg

3-10 hours

144
Q

Pt with OSA and emergence

A

Episodes of hypoxia and hypercapnia during sleep impair arousal mechanism at emergence

145
Q

Dantrolene sodium drug class

A

Ryanodine receptor 1 antagonist

146
Q

Cormack and Lehane laryngoscopic grading system

Visualization of complete laryngeal opening

A

Grade I

147
Q

In almost all cases when do first manifestations of MH occur

A

In the OR

148
Q

Recommended ester for neonatal regional anesthesia and epidural

A

2,3 Chloroprocaine (1.5%)

149
Q

Most common type of CP

A

Spastic

150
Q

Dantrolene MOA

A

Blocks ryanodine receptors and inhibits abnormal Ca release from SR

151
Q

Increased incidence of intra-abdominal tumors with this syndrome

A

Beckwith-Widemann Syndrome

152
Q

Block locations with highest to lowest vascular uptake

A

ICE Block

Intercostal

Caudal

Epidural

Block- peripheral nerve blocks

153
Q

What causes time between loss of airway and resultant hypoxemia causing neurologic injury to be significantly diminished in children

A

Increased metabolic rate

Decreased FRC

154
Q

Structural until of myofibril in muscle

A

Sarcomere

155
Q

Elements of syndrome similar to MH

Sepsi

A

Early normal ABG

Late metabolic acidosis

156
Q

Hypoglycemia with visceromegaly

A

Increased insulin secretion

157
Q

Patients treated with what drugs are susceptible to neuroleptic malignant syndrome

A

Antipsychotic agents

Reflects dopamine depletion in CNS

158
Q

Functions as storage area and release area for calcium in cardiac and skeletal muscle

A

Sarcoplasmic Reticulum (SR)

159
Q

Intranasal fentanyl dose for myringotomy tube insertions

A

1-2 mcg/kg

160
Q

Power house of cell

A

Mitochondrion

161
Q

Hallmarks of cystic fibrosis

A

Elevated sweat chloride

Viscous mucus production

Lung disease

Intestinal obstruction

Pancreatic insufficiency

Biliary cirrhosis

162
Q

In person susceptible to MH what gene abnormality present

A

Ryanodine receptor gene 1 (RyR1)

163
Q

Desaturation of 10kg infant from sat 90% to 0% takes how long

A

4 minutes

Vs 10 minutes in 70kg adult

164
Q

Duration of action of LA is dependent on

A

Concentration

Total dose

Site of administration

Childs age

165
Q

8 actions for initial management of MH

A

DC volatile and succinylcholine

Hyperventilate

Dantrolene

Treat acidosis with bicarb

Lower body temp

Activated charcoal filters, new circuit, new absorbent

Monitor capnography and ABG

Treat hyperkalemia and dysrhythmia

166
Q

Cleft soft palate (no cleft lip)

Micrognathia/retrognathia

Glossoptosis

A

Pierre Robin Sequence

167
Q

Elements of syndrome similar to MH

Hyperthyroidism

A

Minimal ABG

CPK abnormalities

168
Q

How do pharmacokinetics of LA differ in children

A

Rapid absorption

Tissue blood flow higher

Epidural space has less fat to buffer LA

Larger volume of distribution

169
Q

Ryanodex dosage

A

2.5 mg/kg

Repeat as needed up to max of 10 mg/kg

170
Q

Earliest sign of rhabdo

A

Myoglobin blood test

CPK may not rise for several hours

171
Q

How and where does dantrolene work

A

Acts at ryanodine receptor to decrease calcium level in skeletal muscle by decreasing calcium from SR

Skeletal muscle relaxes when Ca supply to contractile proteins impaired

172
Q

Underdeveloped malformed ears

A

Microtia

173
Q

Bupivacaine dos for peripheral nerve blocks

A

0.25%

174
Q

Rhabdomyolysis can result in

A

Damage to kidneys

DIC

175
Q

Spontaneous or controlled ventilation in difficult airway

A

Spontaneous until secure

176
Q

Max recommended dosage and duration

Lidocaine

A

4.5mg/kg

90-200 minutes

177
Q

Does a history of uneventful anesthesia with MH triggering agents rule out susceptibility to MH

A

NO

Pediatrics (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions