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Anesthesia 101 > ITE Peds 3 > Flashcards

ITE Peds 3 Flashcards

1
Q

In a neonate, how do you treat a tension pneumothorax?

A

22g blunt needle or angiocatheter inserted in ipsilateral second intercostal space at midclavicular line,

then insert ped thoracostomy tube

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2
Q

A newborn with a birth complicated by meconium has a __% chance of developing a PTX

A

10%

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3
Q

Cobb angle > __ degrees is indication for surgical intervention d/t worsening of pulmonary complications

A

40

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4
Q

How to intubate pts with halo cervical placement

A

intubate w/o ablating the pt’s ability to spontaneously breathe

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5
Q

Why are neonates predisposed to hypervolemia in setting of overly aggressive volume resuscitation?

A

immature kidneys excrete less water and electrolytes

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6
Q

Peds pt with

  • asymmetric face
  • one sided coloboma (hole in structure of eye)
  • ear tag
  • micrognathia
A

Goldenhar syndrome

- vascular accident affecting 1st and 2nd branchial arches

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7
Q

Peds pt with:

  • craniosynostosis (premature cranial suture ossification)
  • Hypertelorism (inc distance btwn orbits)
  • shallow orbits causing ocular proptosis
  • maxillary hypoplasia
  • Parrot-like beaked nose
  • NO micrognathia
A

Crouzon syndrome

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8
Q

Peds pt with:

  • Micrognathia
  • glossoptosis (displacement of tongue towards pharynx)
  • cleft palate
  • BILATERAL
  • does not involve ears and eyes
A

Pierre Robin Sequence

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9
Q

Peds pt with:

  • underdevelopment of bones of upper jaw
  • downslanting palpebral fissures
  • coloboma of lower eyelid
  • ear abnormalities
  • normal intelligence
A

Treacher collins

- more dysmorphic than robin or goldenhar pts

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10
Q

Peds pt with

  • intellectual disability
  • short stature
  • multiorgan involvement
  • abnl facies
  • abundant secretions
  • large tongue
  • short neck
A

Hurler syndrome

  • AR disorder
  • abnl a-L-iduronidase
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11
Q

5 congenital abnormalities (Goldenhar, Robin, Treacher collins, crouzon) are associated with OSA, ____ has been reported to be useful in all of them

A

Supraglottic airway devices (LMA)

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12
Q

Propofol infusion syndrome is assoc w/ ___ (4)

A
  1. rhabdomyolysis
  2. Lactic acidosis
  3. Renal failure
  4. cardiac failure
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13
Q

A newborn lung is (more/less) compliant compared to adults, and chest wall is (more/less) compliant

A

Lung - less

chest wall - more

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14
Q

MH complications (7)

A
  1. Rhabdo
  2. Myonecrosis
  3. renal failure
  4. hyperkalemia
  5. arrhythmias
  6. DIC
  7. Death
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15
Q

Early warning signs of MH

A
  1. tachycardia
  2. tachypnea
  3. inc ETCO2
  4. masseter muscle spasm
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16
Q

Postconceptual age definition

A

gestational age + age after birth

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17
Q

Postconceptual age of __ weeks correlates to < 1% postop apnea

A

56

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18
Q

______ is the strongest risk factor for post op apnea

A

prematurity

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19
Q

(Centrifugal/Roller) pump flow varies with changes in pump preload and afterload

A

centrifugal pump

20
Q

Roller and centrifugal pumps can deliver adequate systemic pressure during CPB periods via (pulsatile/non pulsatile) flow

A

non-pulsatile

21
Q

(Centrifugal/Roller) pump flow is essentially only dependent on the speed of the rollers

22
Q

(Centrifugal/Roller) pumps have higher incidence of blood element destruction, creation of microemboli, and inflow/outflow obstructions

A

roller pumps

23
Q

(Centrifugal/Roller) pumps are preferred in cardiopulmonary bypass circuits

A

Centrifugal

24
Q 
Recite the normal values
CVP: 
PCWP: 
CI: 
SVR:
A

CVP: 2- 6 mmHg
PCWP: 6 - 12 mmHg
CI: 2.5 - 4 L/min/m2
SVR: 800-1200 dynes*sec/cm5

25
All types of shock except ___ has lowered Cardiac output/index
septic
26
Name that shock! - Decreased CVP - Decreased PAP (pressure after RH) - Increased PVR - Decreased LVEDP - Decreased CO - Increased SVR
Hypovolemic
27
Name that shock! - Decreased SVR - Decreased CVP - Decreased PAP (pressure after RH) - Decreased PVR - Decreased LVEDP - Increased CO
Septic (Distributive shock/vasodilatory)
28
Name that shock! - Increased LVEDP - Decreased CO - Increased SVR - Increased CVP - Increased PAP (pressure after RH) - Increased PVR
Cardiogenic
29
Name that shock! - Increased PAP (pressure after RH) - Nothing PVR - Increased LVEDP - Decreased CO - Increased SVR - Increased CVP
Cardiac tamponade
30
Name that shock! - Increased PVR - (-/decreased) LVEDP - Decreased CO - Increased SVR - Increased CVP - Increased PAP (pressure after RH)
Pulmonary embolism
31
Name that shock! - Decreased CO - Decreased SVR - Decreased CVP - Decreased PAP (pressure after RH) - Decreased PVR - Decreased LVEDP
Neurogenic (Distributive/vasodilatory shock) | - dec CO is from spinal shock/bradycardia
32
Initial landmark identified when performing lateral femoral cutaneous nerve block
anterior superior iliac spine
33
Lateral femoral cutaneous nerve - provides sensory innervation to ____ - derived from __ nerve roots
anterolateral thigh L2-L3
34
How do you perform a Lateral femoral cutaneous nerve block
1 cm medial and 1cm inferior to ASIS, where LFCN is located btwn sartorius and tensor fascia lata
35
Condition where damage to LFCN leads to pain and paresthesias on the lateral upper thigh, which may extend to lateral knee
meralgia paresthetica *LFCN can be entrapped btwn inguinal ligament and the ilium
36
Which one allows passive expiration? High frequency jet ventilation v High frequency oscillatory ventilation
High frequency jet ventilation | - other wise auto-peep can develop
37
Which one allows setting a specific tidal volume? High frequency jet ventilation v High frequency oscillatory ventilation
neither
38
In both High frequency jet ventilation and High frequency oscillatory ventilation, CO2 removal is (directly/indirectly) proportional to frequency
inversely | - higher the frequency, the lower the amplitude (key to CO2 removal)
39
____ most common valvulopathy associated with RA
Mitral valve disease Aortic regurgitation
40
Airway concerns in pts with RA (3)
1. atlantoaxial subluxation 2. TMJ synovitis limit mandibular motion 3. Cricoarytenoid arthritis - hoarseness, pain on swallowing, post-extubation laryngeal obstruction
41
Respiratory alkalosis results in (Hyper/Hypo) calcemia and (Hyper/Hypo)kalemia
Hypocalcemia - Alkalosis --> H+ ions bound to negatively charged albumin is released to offset alkalosis --> Ca2+ binds to albumin *paresthesias can occur with hyperventilation Hypokalemia - H-K transporters pump H+ out of the cell and K+ intracellularly
42
Wind up phenomenon is caused by repeated stimulation of ___ fibers, increasing action potentials at dorsal horn -> amplified response
C
43
When should EPI be administered in non-shockable rhythms?
ASAP
44
When should EPI be administered in shockable rhythms?
defib, then 2 min CPR then defib, then epi
45
The foot is innervated by 5 nerves, but only 4 can be blocked at the ankle. Name them
1. Posterior tibial 2. Sural 3. Superficial peroneal 4. Deep peroneal
46
Law that says that a change in gas volume is inversely related to pressure on the gas
boyle law

Anesthesia 101 (38 decks)

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