Neonatal assessment

Question 1

What is the fetal lung volume

Answer 1

30ml/kg

Question 2

Retained liquid in the lung is thought to cause

Answer 2

transient tachypnea of the newborn (TTN)

Question 3

Lung inflation releases what

Answer 3

surfactant

Question 4

5 parameters of the APGAR score

Answer 4

HR, Respiratory effort, Reflex irritability, color

Question 5

3 characteristics of Persistent Pulmonary HTN of the Newborn

Answer 5

Sustained Elevated PVR
Decreased lung perfusion
Continued R-L shunting (patent foramen ovale and ductus arteriosus)

Question 6

What is the drug of choice in the fetus with bradycardia and decreased CO?

Answer 6

Epinephrine

Question 7

Normal Respiratory Frequency Infant/Adult?

Answer 7

Infant 30-50

Adult 12-16

Question 8

The MV:FRC is _____x higher in the newborn

Answer 8

2-3x

Question 9

Normal TV in Infant/Adult?

Answer 9

Infant 7ml/kg

Adult 7ml/kg

Question 10

Normal FRC in Infant/Adult?

Answer 10

Infant 27-30ml/kg

Adult 30ml/kg

Question 11

_________/________may develop after stimulation of carina or SLN, following AW obstruction, of following lung inflation (Hering-Breuer reflex)

Answer 11

Respiratory depression/Apnea

Question 12

What terminates between L2 and L3 in neonates?

Answer 12

Conus medullaris

Question 13

The neonatal diaphragm is more responsive to (NDMRs or DMRs?)

Answer 13

NDMRs- Like Roc

Question 14

What are some signs of fetal pain?

Answer 14

Tachycardia
Elevated BP
Crying
Restlessness
Grimacing

Question 15

The anterior fontanelle closes by age____

Answer 15

2 y/o

Question 16

The blood/brain barriers is immature until about what age?

Answer 16

1 y/o

Question 17

AW obstruction, Bronchospasm, Pulmonary Aspiration, Inadequate 02 delivery, Pneumothorax

Answer 17

What are respiratory causes of neonatal bradycardia and cardiac arrest?

Question 18

What are Pharmacologic causes of neonatal bradycardia and cardiac arrest?

Answer 18

Inhalation Anesthetics, Succinylcholine, Anticholinesterases (Neostigmine).

Question 19

Celiac reflex, Oculocardiac Reflex, SLN/Recurrent nerve stimulation

Answer 19

What are some neurogenic causes of neonatal bradycardia and cardiac arrest?

Question 20

Hypoglycemia, Anemia, Hypothermia, Acidosis

Answer 20

What are the metabolic causes of neonatal bradycardia and cardiac arrest?

Question 21

Neonates have a ____ GFR and Renal Blood Flow. What is the typical neonatal GFR?

Answer 21

Low GFR- 1.6ml/min/kg

Question 22

GFR reaches normal by _______

Answer 22

1-2 years (12-24 months)

Question 23

What is indicative of hypovolemia or decreased renal function in the neonate?

Answer 23

<1mg/kg/kr

Question 24

Half life of meds are ____ in the neonate.

Answer 24

prolonged

Question 25

Neonates are obligate _____ excreters.

Answer 25

sodium

Question 26

3.0-3.5mm ETT

Answer 26

Appropriate ETT size for the FULL TERM NEONATE

Question 27

What is the most appropriate size ETT for a premature neonate?

Answer 27

2.0-3.0

Question 28

4.0mm ETT

Answer 28

Size ETT for 3month to 12 month old

Question 29

The length of insertion for neonatal ETT should be

Answer 29

<10cm, between 8-10cm

Question 30

Factors affecting metabolism of drugs in the neonate (pick 2)

Answer 30

Volume of distribution Protein binding Fat content

Question 31

Normal cardiac output in the neonate?

Answer 31

200ml/kg/min

Question 32

Why do inhalation agents equilibrate more rapidly in the neonate? (pick 3)

Answer 32

Increased level of ventilation Increased Cardiac Output Reduced Solubility in blood

Question 33

Correct dosage of Atropine in the neonate?

Answer 33

10ug/kg IV | 20ug/kg IM

Question 34

Correct dosage of Glycopyrrolate in the neonate?

Answer 34

0.005-0.01mg/kg (5ug-10ug/kg)

Question 35

Correct dosage of Ketamine in the neonate?

Answer 35

2mg/kg IV | 4-5mg/kg IM

Question 36

What is commonly interpreted as muscle rigidity with bolus doses of Remifentanil above 3ug/kg?

Answer 36

Vocal cord closure

Question 37

Fasting guidelines for clear liquids

Answer 37

2hr- for GA, reginal, MAC

Question 38

Fasting guidelines for light meal or nonhuman milk?

Answer 38

6hr

Question 39

Fasting guidelines for breast milk

Answer 39

4hrs

Question 40

Fasting guidelines for infant formula

Answer 40

6hrs

Question 41

Fasting guideline for fried or fatty food or meat?

Answer 41

8hrs

Question 42

Indication for blood components in perioperative period for major surgery in neonate.

Answer 42

<10 gm/dl

Question 43

Indication for blood components in perioperative period for neonate with moderate cardiopulmonary disease?

Answer 43

<13gm/dl

Question 44

Platelets should be >______ for invasive procedures

Answer 44

50,000

Question 45

How do you calculate postgestational age?

Answer 45

gestational age + postnatal age

Question 46

What postgestational age is the highest risk for complication?

Answer 46

<60 weeks have greatest risk (full term (40wks) +20 weeks).

Question 47

EBV in Premature

Answer 47

90-100

Question 48

EBV in Newborn (<1 month)

Answer 48

80-90

Question 49

EBV in Infants 3mos-3years

Answer 49

75-80

Question 50

EBV in children >6

Answer 50

65-70

Question 51

EBV in adults

Answer 51

65-70

Question 52

Preanesthetic assessment needs to include:

Answer 52

``` Birth Hx Pregnancy Course Complications Cigarette use Alcohol or substance use Primary interest in respiratory and CV Hx Head and neck AW ```