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Apex Review > Pediatrics 2 > Flashcards

Pediatrics 2 Flashcards

1
Q

Which congenital condition is associated with macroglossia?
a. glucose-6-dehydrogenase deficiency
b. Klippel-Feil
c. Treacher Collins
D. Trisomy 21

A

D. trisomy 21

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2
Q

Which conditions present with small/underdeveloped mandible?

A

Pierre Robin
Goldenhar
Treacher Collins
Cri du Chat
Please Get that chin

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3
Q

Which conditions present with cervical spine anomaly?

A

Klippel-Feil
Trisomy 21
Goldenhar
(Kids Try Gold)

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4
Q

Which conditions present with large tongue?

A

Beckwith syndrome
Trisomy 21
(Big Tongue)

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5
Q

Anesthetic considerations for cleft lip and palate include

A

airway obstruction
difficult laryngoscopy
difficult mask ventilation
aspiration

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6
Q

__________________ can reduce venous drainage and cause tongue engorgement

A

the Dingman-Dott mouth retractor

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7
Q

The Dingman-Dott mouth retractor can lead to

A

post-extubation airway obstruction

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8
Q

Neonates with Pierre Robin syndrome often require

A

intubation

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9
Q

Pierre robin syndrome is made up of

A

small/underdeveloped mandible
cleft palate
tongue that falls back and downwards (glossoptosis)

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10
Q

Treacher collins is composed of

A

small mouth
small/underdeveloped mandible
choanal atresia
ocular and auricular anomalies

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11
Q

Trisomy 21 is composed of

A

small mouth
large tongue
atlantoaxial instability
subglottic stenosis

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12
Q

Klippel-Feil is composed of

A

congenital fusion of cervical vertebrae–> neck rigidity

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13
Q

Beckwith syndrome is composed of

A

large tongue

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14
Q

Goldenhar syndrome is composed of

A

cervical spine abnormality
Small/underdeveloped mandible

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15
Q

Cri du Chat is composed of

A

small/underdeveloped mandible
laryngomalacia
stridor

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16
Q

Cleft lip repair is typically performed at

A

~1 month of age

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17
Q

Cleft palate repair is typically performed at

A

~12 months of age

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18
Q

What is the MOST common cardiac anomaly associated with Down syndrome?
a. atrioventricular septal defect
b. 1st degree heart block
c. bicuspid aortic valve
d. single ventricle

A

a. atrioventricular septal defect

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19
Q

_______________ is the most common chromosomal disorder.

A

Trisomy 21 (down syndrome)

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20
Q

The patient with down syndrome is at an increased risk for

A

difficult ventilation and intubation

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21
Q

Reasons the patient with down syndrome is at an increased risk of difficult ventilation and intubation include

A

small mouth
large tongue
midface hypoplasia
palate is narrow with a high arch
atlantoaxial instability
subglottic stenosis
obstructive sleep apnea
chronic pulmonary infection

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22
Q

Co-existing issues with trisomy 21 include

A

congenital heart disease
low muscle tone
GERD
intellectual disability

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23
Q

__________ are most likely to give birth to a child with down syndrome

A

Older mothers

24
Q

Trisomy 21 results from

A

the addition of a 3rd copy of chromosome 21

25
Q

What should be avoided during laryngoscopy of the patient with trisomy 21?

A

neck flexion

26
Q

Due to their subglottic stenosis in patients with down syndrome,

A

use a smaller ETT
they have increased risk of postintubation croup

27
Q

The most common co-existing congenital heart disease in patients with trisomy 21 is

A

AV septal defect
VSD is second most common

28
Q

___________ is very common during induction with trisomy 21

A

bradycardia with sevoflurane induction (give anticholinergic)

29
Q

Match each congenital condition with its MOST likely presentation.
Catch 22 (DiGeorge) syndrome
VACTERL Association
CHARGE association
Choanal atresia
renal dysplasia
hypocalcemia

A

Catch 22- hypocalcemia
CHARGE- Choanal atresia
VACTERL- Renal dysplasia

30
Q

Describe VACTERL association.

A

Vertebral defects
imperforated anus
Cardiac anomalies
tracheoesophageal fistula
esophageal atresia
renal dysplasia
limb anomalies

31
Q

Describe CHARGE association.

A

Coloboma
Heart defects
Choanal Atresia
Restriction of growth and development
Genitourinary problems
Ear anomalies

32
Q

Describe CATCH 22

A

Cardiac defects
abnormal face
thymic hypoplasia
cleft palate
hypocalcemia
22q11.2 gene deletion (the cause of the syndrome)

33
Q

What is coloboma?

A

a hole in one of the eye structures

34
Q

What is choanal atresia?

A

back of nasal passage is obstructed

35
Q

For the child with DiGeorge syndrome, if the thymus is absent

A

the child is at a high risk for infection

36
Q

Treatment for an absent thymus consists of

A

thymus transplant or mature T cell infusion

37
Q

Transfusion of ______________ for DiGeorge syndrome is best

A

leukocyte-depleted irradiated blood

38
Q

What factors lower ionized Ca2+?

A

hyperventilation
albumin
citrated blood products

39
Q

What is the MOST common coagulation disorder in children undergoing adenotonsillectomy?
a. Hemophilia A
b. Heparin-induced thrombocytopenia
c. Sickle cell disease
d. von Willebrand disease

A

d. Von willebrand disease

40
Q

The most common pediatric surgical procedures are

A

tonsillectomy and adenoidectomy

41
Q

Indications for tonsillectomy and adenoidectomy include

A

nocturnal upper airway obstruction and chronic and/or recurrent infections

42
Q

The most common cause of OSA in kids is

A

adenotonsillar hypertrophy

43
Q

The most common coagulation disorder in patients undergoing tonsillectomy is

A

Von Willebrand disease

44
Q

_________ may reduce postoperative airway swelling, pain, and PONV with tonsillectomy.

A

Decadron 1 mg/kg up to 25 mg

45
Q

With tonsillectomy and adenoidectomy there is a risk of

A

airway fire (maintain FiO2 <40% and avoid nitrous oxide)

46
Q

Children with OSA undergoing adenotonsillectomy should be

A

admitted to the hospital for 23 hours and receive monitoring for airway obstruction

47
Q

_________________ is a surgical emergency

A

Post-tonsillectomy bleeding

48
Q

Key anesthetic risks for post-tonsillectomy bleeding include

A

hypovolemia
aspiration

49
Q

Patients with post-tonsillectomy bleeding should receive

A

volume resuscitation & a RSI

50
Q

Children with OSA undergoing adenotonsillectomy have a ______________________ & should receive

A

longer emergence from anesthesia; a lower intraoperative opioid dose

51
Q

_____________ should not be given to children with OSA undergoing adenotonsillectomy because__________

A

codeine for postop pain d/t an increased risk of death d/t respiratory depression

52
Q

Children with OSA undergoing adenotonsillectomy have an increased incidence of

A

postop airway obstruction
prolonged oxygen requirements
greater need for airway instrumentation

53
Q

Patients who receive DDAVP are at risk for

A

hyponatremia (use isotonic crystalloids at 1/2-2/3rds calculated maintenance values)

54
Q

Primary bleeding occurs within

A

the first 24 hours (post-tonsillectomy) with 75% occurring within the first 6 hours after surgery

55
Q

Secondary bleeding typically occurs

A

5-10 days after tonsillectomy when the scar covering the tonsil bed contracts

56
Q

____________ and ____________ are suggestive of a >20% loss of circulating volume

A

Dizziness and orthostatic hypotension

57
Q

How should the post-tonsillectomy bleeding patient be induced

A

preoxygenated in the left-lateral and head down position helps drain blood from the airway
RSI
OGT after induction

Apex Review (224 decks)

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